American Journal of Psychiatric Rehabilitation
Welcome to the American Journal of Psychiatric Rehabilitation ISSN: 1548-7776 Open Access | Peer-Reviewed | Continuous Publication The American Journal of Psychiatric Rehabilitation is a peer-reviewed, open-access journal committed to publishing high-quality research and scholarship focused on psychiatric rehabilitation, mental health recovery, and related service systems. The journal provides a platform for the dissemination of knowledge that supports individuals with mental health conditions in achieving meaningful life outcomes through evidence-based interventions, service innovations, and recovery-oriented practices. The journal invites original empirical studies, reviews, and theoretical or policy-focused contributions that reflect interdisciplinary perspectives from fields such as psychiatry, psychology, social work, public health, occupational therapy, and education. Priority is given to work that advances understanding of rehabilitation practices, community integration, and systemic responses to mental health challenges. Published articles follow a continuous publication model and are made freely available under an open access license, ensuring wide dissemination and accessibility to researchers, practitioners, and policy stakeholders. Scope of the Journal - Psychiatric rehabilitation and recovery models - Psychosocial and cognitive-behavioral interventions - Community-based mental health services - Education, employment, and housing support in mental health care - Integrated care models and systems-level approaches - Mental health policy, training, and service evaluation This journal aims to support academic inquiry and practical innovation in psychiatric rehabilitation by fostering a space for knowledge exchange across clinical, academic, and community-based settings.
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Exploring The Influence Of Physical Exercise On Personality Development: A Systematic Review
Background: Personality development is a multifaceted process influenced by various factors, including genetic predispositions, environmental influences, and individual experiences. In recent years, the role of physical exercise in shaping personality traits has garnered increasing attention from researchers and practitioners alike. Aim: This review aims to consolidate existing literature and provide insights into the relationship between physical exercise and personality development. By examining empirical studies and theoretical frameworks, we explore the mechanisms through which exercise influences personality traits, such as extraversion, conscientiousness, openness, agreeableness, and emotional stability. Additionally, practical implications and recommendations for future research are discussed to elucidate the potential of physical exercise interventions in fostering positive personality growth.
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LEVEL OF COPING SELF EFFICACY AMONG YOUTH IN FISHERMEN COMMUNITY, ALAPPUZHA DISTRICT, KERALA
The ultimate development of every community is confided on the bright future of the youth. The development of youth is closely associated on the proper care and attention which they are getting from the state, society and community. The youth in fishermen community are facing lot of psycho-social problems and challenges and it also affects their physical and mental well being. The level of coping self efficacy among the youth in this community is very low. The same findings reported by Frank Elgar in his study conducted on 2013 among the resilience and strategy of self efficacy among youth in fishermen community. Coping of stress in life is very much important for the overall mental wellbeing and development. Self-efficacy denotes people's beliefs about their ability to perform in different situations. It functions as a multilevel and multifaceted set of beliefs that influences how people feel, think, motivate themselves, and behave during various tasks. Self efficacy of youth is closely associated with the cognitive, motivational, affective, and selection processes to generate actual performance and personal experiences. Between18 to 29 years old youth in fishermen community are facing lot of psycho-social problems and challenges. The character of a person is moulded in this period only. In this study the researcher adopted quantitative research design which is descriptive in nature. 40 samples were selected through simple random sampling method from the population. Coping Self Efficacy Scale (CSES) developed by Chesney et al. (2006), was used. The paper will conclude with strategies to enhance self-efficacy among the youth.
Assessing and addressing behavioral and physical health status and unmet needs of student Veterans with supported education
Objective: Assess the behavioral and physical health status and unmet healthcare needs among college student Veterans and the outcomes of a pilot of a supported education intervention on health status and healthcare utilization. Methods: Supported education services were provided to 41 student Veterans seeking help with academic performance at college campuses for up to 1.5 semesters. Results: Thirty-six Veterans (87.8%) met cut-off criteria for one or more behavioral or physical health conditions. Thirty of those (83.3 %) had zero healthcare appointments in the previous six months. Among those with unmet needs, there were larger reductions in the percentage of Veterans with health conditions among the intervention group compared to the control group. A larger proportion of Veterans with unmet healthcare needs in the intervention group reported having at least one healthcare appointment than did Veterans in the control group.
Clinicopathological Correlation Of Er, Pr And Her 2 Neu In Epithelial Ovarian Tumors
Background: Expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor‑2 (HER2/neu) may reflect tumor biology and prognostic strata in epithelial ovarian tumors (EOTs). We evaluated their immunohistochemical (IHC) expression and clinicopathological correlations in a North Indian cohort. Methods: In a five‑year study (2010–2015) at SKIMS, 50 consecutive EOTs were analyzed (benign, borderline and malignant). Routine histopathology and IHC for ER, PR and HER2/neu were performed on formalin‑fixed paraffin‑embedded tissue. Intensity was semi‑quantitatively graded (0/1+/2+/3+). For HER2/neu, 1+ was considered negative. Clinicopathological variables included histotype, grade, FIGO stage, nodal status, lymphovascular invasion (LVI), capsular invasion, metastatic status and pre‑operative CA‑125 where available. Results: Of 50 EOTs, 8 (16%) were benign, 9 (18%) borderline and 33 (66%) malignant. Among malignant tumors, serous histology predominated (23/33; 69.7%), followed by mucinous (9/33; 27.3%) and clear cell carcinoma (1/33; 3.0%). ER was positive in 30/33 malignant cases, PR in 28/33 and HER2/neu in 5/33; all benign and borderline tumors were HER2/neu‑negative. High‑grade carcinomas more often showed higher ER and PR expression than low‑grade tumors. ER/PR positivity was enriched in cases with adverse features (metastasis, LVI, capsular invasion), while HER2/neu was largely negative across strata. Stage‑3 tumors showed higher ER/PR intensity compared with stage‑1/2. Elevated CA‑125 was more frequent in high‑grade than low‑grade disease. Conclusions: In this cohort, ER and PR expression was significantly more frequent and stronger in malignant versus benign/borderline EOTs, and associated with higher grade and advanced stage, whereas HER2/neu overexpression was infrequent and restricted to carcinomas. These findings support potential utility of ER/PR profiling for prognostication and selection for endocrine strategies in ovarian carcinoma, while HER2/neu appears to have limited role in this setting.
PHQ-9 Based Screening Of Psychiatric Illness In The Antenatal Period And Its Progression – A Cross Sectional, Prospective Study At A Tertiary Care Centre In Central India
Introduction: Antenatal psychiatric disorders, particularly depression and anxiety, are among the most prevalent complications of pregnancy and can have significant short- and long-term consequences for both maternal and fetal health. Aims & Objectives: To screen pregnant women using PHQ-9 for high-risk psychiatric symptoms and confirm diagnoses through further evaluation, aiming for early detection and management to improve maternal and fetal outcomes. Materials & Methods: This prospective, observational, hospital-based study was conducted at Government Medical College, Nagpur, India. The total study duration was 18 months, divided into three distinct phases for systematic data collection and analysis. The study population comprised all pregnant women attending the antenatal care (ANC) outpatient department (OPD) during the study period, with a total sample size of 141 participants. Result: In our study of 141 antenatal women, most were aged 26–30 years, married, and from lower or lower-middle socioeconomic backgrounds. PHQ-9 screening showed 32.6% had minimal, 44.7% mild, 16.3% moderate, 5.7% moderately severe, and 0.7% severe depression. Depressive symptoms were significantly more common among women from lower socioeconomic classes. These findings highlight a high prevalence of antenatal depression, emphasizing the need for routine PHQ-9 screening and early mental health intervention during pregnancy. Conclusion: The study underscores that antenatal depression is common, especially among women with lower socioeconomic status, limited education, or rural residence. Most exhibited mild to moderate symptoms such as fatigue, poor sleep, and low mood, highlighting the need for early detection through routine PHQ-9 screening, counseling, and integrated mental health support to improve maternal and fetal outcomes.
Enhancing Motor Function and ADLs through Task-Oriented Training with Proprioceptive Training in a Post Craniotomy Patient :- A case report
Objective: To evaluate the effectiveness of combining proprioceptive stimulation and task-oriented training (TOT) on motor recovery and functional independence in a post-craniotomy patient. Design: Single-subject case study. Setting: Deep Hospital and Research Centre, Jaipur, Rajasthan. Intervention: An 8-week physiotherapy program consisting of phased proprioceptive training (stable, dynamic, and functional stages) followed by structured TOT targeting upper- and lower-limb functional movements. Sessions were conducted 5 days per week for 45–60 minutes. Outcome Measures: Fugl-Meyer Assessment (FMA) and Motor Assessment Scale (MAS), recorded pre- and post-intervention. Results: Post-intervention scores showed substantial improvement in motor control, balance, and functional task performance. FMA scores increased from 78 to 118 and MAS scores improved from 18 to 42, indicating enhanced motor function and greater independence in ADLs. Conclusion: The combined proprioceptive and task-oriented training approach was effective in promoting early motor recovery and functional independence following craniotomy, suggesting its applicability in neurorehabilitation settings.
A Case Report on Premenstrual Syndrome (PMS) and Its Homoeopathic Management
Premenstrual Syndrome (PMS) is a group of physical and emotional symptoms that occur cyclically in the luteal phase of the menstrual cycle. It significantly affects the quality of life in women of reproductive age. Conventional treatment often provides symptomatic relief with side effects, where as homoeopathy offers a holistic, individualized treatment targeting the root cause rather than just symptom suppression. There is a case study of 25 years old woman with classical symptoms of PMS who was treated using a constitutional approach after detailed case-taking and repertorization. Follow-ups were conducted over three menstrual cycles. The patient responded positively to the homoeopathic remedy, showing marked improvement in physical and emotional symptoms over a period of three months. This case demonstrates that individualized homoeopathic treatment can provide safe, effective, and long-term relief from PMS.
Cognitive gaps in education: analysis of neurodidactic experiences and guidelines for an inclusive policy
This study explores the transformative potential of neurodidactics as a pedagogical approach to strengthen cognitive skills in students from vulnerable environments across Latin America. It focuses on key competencies such as focused attention, working memory, emotional self-regulation, and cognitive flexibility—essential for deep learning. Recognizing that adverse socioeconomic conditions negatively impact these abilities (Diamond, 2013), the research emphasizes the need for educational responses grounded in recent neuroscientific evidence (Carew & Magsamen, 2023; Howard-Jones et al., 2022). The study adopts an empirical qualitative approach with an interpretative-comparative design, analyzing documented experiences in Mexico and Colombia, where public institutions have implemented programs such as “Aula Neurodidáctica” and “Neuroeducación para la equidad.” It draws on official reports (SEP, MEN, UNESCO), pilot project evaluations, and triangulation of academic, institutional, and testimonial sources. Through comparative matrices and thematic coding, the research identifies causal links between the implementation of neurodidactic strategies and improvements in school-based cognitive skills, proposing their integration into inclusive public policies and teacher training frameworks.
Phytochemical And Pharmacological Activities Of Wood Apple: A Systemic Review
Background: Wood apple, botanically known as Feronia elephantum syn. Limonia acidissima, is a member of the Rutaceae family and has been valued in Ayurveda for its multifaceted medicinal properties. Traditionally used in managing various ailments, the plant is reported to be rich in significant pharmacological activities that include hypoglycaemic, hepatoprotective, antitumor, antimicrobial, and larvicidal effects, among others. The observed therapeutic benefits of this plant are attributed to bioactive phytochemicals, including alkaloids, flavonoids, polyphenols, lignans, and terpenoids. Despite its extensive use in traditional medicine, its phytochemical and pharmacological profile needs consolidation through a systematic review. Objectives: The present review aims at compiling and analysing the existing scientific literature on the phytochemical composition and pharmacological activities of Wood apple, providing full insight into its medicinal potential. Methods: This study presents a critical review of the literature about Wood apple, conducted in major databases like PubMed, ScienceDirect, Web of Science, Scopus, and Google Scholar for articles published between 2010 and 2024. The search was conducted by using keywords such as Wood apple, Feronia elephantum, Limonia acidissima, phytochemistry, and pharmacological activities associated with Boolean operators (AND/OR). Based on a structured selection process, only studies that described the phytochemical constituents and pharmacological activities of Wood apple were included. Results: A review of literature revealed the presence of bioactive principles, which are responsible for its therapeutic use. Experimental studies indicated that Wood apple possesses antidiabetic, hepatoprotective, antimicrobial, Anti-hyperlipidaemic and anti-inflammatory activities. Besides, preclinical studies have pointed out its potential role in fighting against oxidative stress and metabolic disorders. Conclusion: Wood apple (syn. F. elephantum, L. acidissima) is a rich source of bioactive phytochemicals like flavonoids, coumarins, alkaloids, essential oils, phenolic compounds, tannins, steroids, triterpenoids, carbohydrates, and amino acids. These are the constituents responsible for the wide pharmacological activities of this plant and, therefore, represent an important plant within traditional and modern medicine. Further research is needed to explore the full potential of F. limonia in drug development and nutritional applications.
Mapping Associations Between Smartphone Addiction and Physical Psychosocial Outcomes in Young Adults: A Review
Smartphones have become indispensable tools in modern life, particularly among young adults who rely on them for communication, education, and entertainment. However, rising patterns of excessive and uncontrolled use often described as smartphone addiction are increasingly linked to a wide spectrum of adverse physical and psychosocial outcomes. This review aims to synthesize current evidence on the associations between smartphone addiction and health consequences in young adults, with emphasis on physical, psychosocial, and interconnected outcomes, while identifying research gaps and future directions. Evidence indicates that smartphone addiction is consistently associated with musculoskeletal strain, forward head posture, reduced neck muscle endurance, repetitive strain injuries, and sleep disruption. Psychosocial consequences include heightened anxiety, depressive symptoms, low self-esteem, fear of missing out (FoMO), and poorer academic performance. Notably, these outcomes interact bidirectionally: for example, sleep disturbance exacerbates musculoskeletal pain and psychological distress, while chronic discomfort increases vulnerability to stress and low mood. Cross-cultural research reveals varying prevalence and risk factors, with up to one-third of young adults in India exhibiting problematic smartphone use. Despite growing evidence, research is limited by inconsistent diagnostic criteria, heavy reliance on cross-sectional designs, and lack of longitudinal or mechanistic studies. In conclusion smartphone addiction in young adults represents a multidimensional health concern with interlinked physical and psychosocial effects. Addressing current gaps requires standardized diagnostic frameworks, longitudinal and interventional studies, integration of objective measures, and greater representation of diverse populations. Future directions should focus on developing preventive and therapeutic interventions, including digital literacy programs, ergonomic training, and psychosocial support. A multidisciplinary approach engaging healthcare providers, educators, policymakers, and technology developers will be critical to mitigating risks and promoting healthier digital habits among young adults.
‘Effect Of Lakshakuttan Navak Guggulu Versus Samanya Navak Guggulu On Medovirdhi: A Randomized Experimental Study”
Medovriddhi (obesity) is a lifestyle disorder characterized by excessive accumulation of Meda Dhatu (adipose tissue), leading to metabolic imbalance and associated health risks. In Ayurvedic classics, Navaka Guggulu is prescribed for the management of Sthoulya (obesity) due to its Lekhana (scraping), Medohara (fat-reducing), and Agnideepana (digestive) properties. Lakshakuttan Navaka Guggulu is a modified formulation enriched with Laksha (Laccifer lacca), known for its bioactive and lipid-reducing properties. Guggulu Kalpana, a part of Vati Kalpana is very much effective in combating various diseases, the only limitation being its Disintegration time and Hardness. It has been found clinically that Guggulu kalpana usually pass in the faeces un-disintegrated or partially absorbed. To overcome this, the Kuttana (pounding) method is mentioned to facilitate quick disintegration which in turn helps in quick absorption of Guggulu in the body.1 This study aimed to evaluate and compare the efficacy of Lakshakuttan Navaka Guggulu with the standard Navaka Guggulu in the management of Medovriddhi.
Understanding PCOS Through The Lens Of Sthoulya (Obesity) And Artava Kshaya: An Integrated Ayurvedic Approach To Metabolic And Reproductive Dysfunction
Polycystic Ovary Syndrome (PCOS) is a heterogeneous metabolic–reproductive disorder characterized by insulin resistance, obesity, hyperandrogenism, and chronic anovulation. This article presents an integrated Ayurvedic interpretation of PCOS through the dual frameworks of Sthoulya (obesity/Medoroga) and Artava Kshaya (diminished menstrual function). The proposed Kapha-Meda Avarana model explains how systemic metabolic derangement, originating from Agnimandya and Medo Dhatvagni dysfunction, leads to Meda vriddhi and subsequent obstruction of the Artavavaha Srotas. This obstruction impairs Apana Vata, resulting in anovulation, oligomenorrhea, and follicular arrest—clinical parallels of PCOS. The article also differentiates Sthoulya-linked PCOS from lean phenotypes, highlighting distinct doshic drivers. A comprehensive therapeutic protocol integrating Shodhana, Shamana, Tarpana, and Uttara Vasti is presented, demonstrating significant improvements in metabolic parameters, normalization of ovarian morphology, restoration of ovulation, and high conception rates in clinical observations. The findings support Ayurveda’s capacity to address both the metabolic root (Sthoulya) and the reproductive manifestation (Artava Kshaya), offering a causally coherent and effective management approach for PCOS.
Exploring The Roles And Responsibilities Of Principals In School Governance In Zambezi Region, Namibia
The purpose of this study was to explore the roles and responsibilities of principals in school governance in Zambezi region, Namibia. This study is located within the interpretive paradigm. A qualitative research approach was employed. To solve the problem in this study, the researchers narrowed the population so that only principals from the Zambezi region formed part of the study. Purposive sampling was employed in this study. The researchers made choices regarding which participants or groups to include in the sample and selected five principals to explore the roles and responsibilities of principals in school governance in Zambezi region, Namibia. The researchers utilized interviews as data collection technique in this study. A qualitative data analysis (QDA) was employed in this study. It was established from the findings that principals’ roles and responsibilities in school governance were immense. They had to ensure that the curriculum and day-to-day activities of the school were implemented. It, furthermore, states that the principal has to implement the school curriculum and ministerial policies. It was revealed that principals maintained discipline at the school for both teachers and learners. It was also their responsibility to ensure that the infrastructure was maintained.
Prescription Pattern of Analgesics for Pain Relief in Post-Operative Orthopedic Patients in Tch
Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Uncontrolled pain is a major impediment to post-operative functional recovery and is a persistent problem. Older adults who undergo lower extremity orthopaedic surgery (e.g., hip and knee arthroplasty, hip fracture repair) experience intense post-operative pain and are at risk for sub-optimal analgesic therapy. Higher pain levels following lower extremity orthopaedic surgery have been associated with increased lengths of stay, increased complications, delays in ambulation, impaired functional recovery, and increased suffering. Aim: This main aim of the study is to assess the intensity of pain in patients in orthopaedic unit; and to describe the analgesia plan and drugs used. Objectives: Prescribing trends of analgesics in postoperative orthopaedic patients. Assessing the intensity and relief of pain in postoperative orthopaedic patients. Tolerability assessment by monitoring the incidence of adverse events. Methodology: A total of 155 patients were included in this hospital based prospective, observational study conducted in orthopaedic department at Lalitha Super Specialty Hospital. Patients were included based on inclusion and exclusion criteria, and reviewed daily to study the effect of analgesic drugs in post-operative patients. The data was collected on the patient profile form. Pain assessment was done once a day, during immediate postoperative (IPO) period- until 24 hours after surgery; 1st postoperative period (1stPO) - from 24 to 48 hours after surgery; and 2nd postoperative (2ndPO) period - from 48 to 72 hours after surgery in these patients was done through Visual Analog Scale (VAS), Verbal pain intensity scale, 0 – 10 numeric pain intensity scale and faces scale. Results: Mean average of 1st PO, 2nd PO and 3rd PO results were assessed. Paired t-test was conducted to assess the comparison of pain relief according to age for the patients 50 years (1st PO – 8.07±0.97, 2nd PO – 6±1.46 and 3rd PO – 3.5±1.23). Based on these findings, Severity of pain is more in >50 years group (7.82), than in < 50years group at first post-operative period (8.07). But the mean 2nd PO period pain was decreased similarly in both groups (3.5). Pain assessment score was also done in combination of analgesics. Based on P value obtained, Tramadol + Aceclofenac combination was found to be effective. Conclusion: The study, analgesics prescribing pattern and assessing the intensity and relief of pain in postoperative orthopaedic patients concluded that the rational use of analgesics had decreased the pain on 3rd postoperative day.
“Assess awareness on self-care activity regarding lifestyle modification among diabetic mellitus patient in selected rural areas of Maharashtra”.
Introduction: Diabetic mellitus is one of the most common noncommunicable diseases in India. The acute and chronic complications of Diabetic mellitus affect the physical, mental, and social well‑being of the patient, thereby, causing heavy burden on the health care system. Previous research Studies have demonstrated that adequate self‑care activity among the patients will facilitate good glycemic control and prevent complications. Objectives: To assess the existing awareness regarding lifestyle modification on self-care activity among diabetic mellitus patient and To determine the association between awareness about self-care activity of diabetic mellitus patient with selected demographic characteristics. Methods: This descriptive cross‑sectional study was carried out among 110 diabetic mellitus patient in the selected rural area of Maharashtra the participants were interviewed on their diabetic status and various components of self‑care activity adopted from The Summary of Diabetic Self‑care activity regarding lifestyle modification questionnaire prepared by investigator and validated by experts. Results: Our study observed that the overall prevalence of self‑care activity regarding lifestyle modification was very poor (58.18%). Average self‑care activity was prevalent in 41.82% of the study. In our study, the association between self‑care activities with educational status was found to be statistically significant. Conclusion: this research study highlight on the need for awareness to be provided in rural areas regarding Diabetic mellitus care self‑care activity. planned programs need to be organize to improve self care activity of diabetic mellitus patient to promote better health compliance regarding diet, exercise, adherence to drugs, and appropriate foot care regarding lifestyle modification.
Brief Psychodynamic Psychotherapy For Dissociative Disorder: A Case Study In Rural India
Patient Profile 24 years female, married, presented with multiple episodes of dissociation and hyperventilation, Mrs. S.A. Such symptoms were noticeable after a stressful period and more so when she was physically away from her husband. This case provides evidence of Dissociative Mixed type . Case Formulation Presenting Complaints Mrs. S.A. had filed episodes of transient loss of awareness and breathlessness, which was lasting about 15-20 minutes. These symptoms worsened during his absence and her previous episodes were in the last 6 years. Psychodynamic Factors The patient showed an unsuccessful resolution of the conflict of intimacy against isolation, this shows that the patient is at the phallic-genital phase, in client’s childhood there was disorganized attachment and the client manifests fear of abandonments. These coping mechanisms were unhealthy, with primary defense being dissociation. Therapeutic Approach Goals of Therapy Specifically, the therapy was intended to decrease symptoms, improve memory, consciousness and identity and cultivate secure attachment as well as interpersonal skills. Therapeutic Process Intervention was 12 sessions of brief psychodynamic psychotherapy. It was on the creation of working alliance, assessment of attachment history, examination of early object relationships and defense organization, and brought in CBT approaches in a later stage. Outcomes and Follow-up Therapeutic Outcomes: The dissociative episodes of the patient were not observed at the end of the therapy. The subject was more educated about her professionals concerning her attachment patterns, problem solving ability, and self-awareness enhancements. Follow-up Plan Subsequent weekly sessions aimed to report on behavioral and emotional changes, evaluate the quality of attachment, and identify changes in role expectations as well as to offer further support in the retention of gains Conclusion This case study, therefore, aims at showing how even brief psycodynamic psychotherapy can help dissociative disorder. Changing the patient’s patterns of attachment and defense mechanisms proved effective of which the patient’s symptoms and overall functioning improved.
A Urodynamic Study On The Prevalence And Patterns Of Bladder Dysfunction In Rural Postmenopausal Women With Lower Urinary Tract Symptoms
Lower urinary tract symptoms (LUTS) are highly prevalent among women and increase substantially with advancing age, often leading to social embarrassment, psychological distress, and deterioration in overall quality of life. LUTS encompass storage, voiding, and post-micturition symptoms, including urgency, frequency, nocturia, weak stream, and incomplete emptying. Globally, up to 70% of adult women report at least one LUTS, with the prevalence rising sharply in postmenopausal groups due to hormonal, anatomical, and neuromuscular changes affecting the bladder and urethra.[1]
Exploring the Quantitative Interplay between Academic Performance And Self Esteem among School Students
Academic Performance and Self Esteem are both the important, reliable and interrelated components in student's lives, as they are struggling on both the aspects in order to enhance their academic performance as well their self esteem with different methodologies as per their adaptability. Academic performance affects the self esteem of students overall depending on the context and perspective of time. The present study intends to comprehend the relationship between academic performance and self esteem among school students who are at the stage of transition in their lives following every aspect of change. The study is likely to determine and evaluate the various psychological techniques that are responsible to enhance academic performance and the self esteem of school students. For the conduction of present study, (100) sample of school going students were randomly selected and the data was collected by using "Academic performance rating scale" (APRS), developed by Dupaul, Rapport &Perriello (1991) and "Rosenberg's Self Esteem Scale (RSE), developed by Rosenberg (1979). For the derivation of results, t- test and Karl Pearson's correlation method was effectively used. The study had shown the positive as well beneficial results for the school students while making them aware about the role and significance of academic performance & self esteem in their lives and also how to upgrade these both components with alternative methodologies.
Comparative evaluation on efficacy of Habb-e-Rasuat versus Habb-e-Muqil in Internal Haemorrhoids of Grade I and II (Bawaseer Ghaira) – An open label Randomized clinical trial.
Background and Objective: Hemorrhoids are a prevalent anorectal condition worldwide, with substantial social and economic consequences. Conservative treatments typically include life-style modifications, increased fiber intake, and non-surgical methods such as Sclerotherapy and rubber band ligation. When these measures fail, surgical interventions are often required. Though effective, surgery carries potential complications like bleeding, pain, prostatitis, urinary retention, stricture formation, anal incontinence, and infections, prompting a shift towards less invasive options. In Unani medicine, remedies like Habb-e-Rasuat and Habb-e-Muqil treat internal hemorrhoids (Bawaseer-e-Ghaira) by relieving symptoms and addressing the root cause. Given the potential benefits of these treatments, it is essential to evaluate their efficacy using modern scientific parameters. A clinical investigation comparing the effects of Habb-e-Rasuat and Habb-e-Muqil on internal hemorrhoids could provide a viable alternative to expensive and painful surgical procedures. Materials and Methods: A randomized, open-label clinical trial was conducted at NIUM hospital involving 40 participants divided into two groups. Group A (20 participants) received Habb-e-Rasuat (200 mg; 2 pills twice daily), and Group B (20 participants) received Habb-e-Muqil (200 mg; 2 pills twice daily). The efficacy of the treatments was evaluated based on subjective and objective assessment parameters by using PNR-Bleed classification and HSS (Haemorrhoid severity score) such as rectal bleeding, prolapse of pile mass, Number of haemorrhoidal columns, rectal mucosa, grading of pile mass, bleeding points, and anal sphincter spasm. Results: Both groups showed significant improvement in symptoms. Group B (Habb-e-Muqil) demonstrated superior results in reducing rectal bleeding, (P-values < 0.001-0.002), while Group A (Habb-e-Rasuat) was more effective in alleviating prolapse of pile mass (P-value < 0.001). Both treatments were equally effective in reducing number of haemorrhoidal columns, anal inflammation, and sphincter spasm with no adverse effects observed. PNR-B and HSS scores have shown significant improvements in the symptoms of Haemorrhoides (P-value <0.001). Interpretation and Conclusion: The study suggests that both Habb-e-Rasuat and Habb-e-Muqil provide similar improvement in overall outcomes for treating internal hemorrhoids by addressing a broader range of symptoms. Habb-e-Muqil was better in reducing bleeding and Habb-e-Rasuat fared better in reducing the size of prolapsed pile mass, and mucosal inflammation.
Mode Of Action Of Akshi Tarpana – A Critical Review Based On Ayurvedic Principles
Akshi Tarpana is one of the foremost Netra Kriyakalpa procedures described in classical Ayurvedic texts for maintaining ocular health and treating various Netra Rogas. The term Tarpana denotes nourishment and satisfaction of ocular tissues through the retention of medicated Sneha Dravyas (primarily Ghrita or Taila) over the eyes for a prescribed duration. Despite its wide clinical application, the precise mode of action of Akshi Tarpana has not been adequately elaborated in classical or modern literature.The present review critically analyses its mechanism of action on the basis of Ayurvedic principles of Dosha, Dhatu, Srotas, Guna, and Karma. According to Ayurveda, Akshi Tarpana primarily pacifies Vata and Pitta Doshas, which are chiefly responsible for ocular dryness, fatigue, and inflammation. The Sneha Dravyas used in the therapy possess Snigdha, Mridu, Sukshma, and Sara Gunas, which facilitate deep penetration, lubrication, and nourishment of the Drishti Mandala and Netra Srotas. The Rasayana and Chakshushya properties of the medicated Ghrita promote ocular rejuvenation and clarity of vision by enhancing Alochaka Pitta. The mild Swedana (sudation) effect produced during the procedure improves local circulation, removes Srotorodha, and enhances Drishti Poshana.Overall, Akshi Tarpana exerts a soothing, stabilizing, and rejuvenating effect on ocular physiology, corresponding to the Ayurvedic concepts of Indriya Prasadana and Netra Brimhana. Hence, it serves as a holistic ocular therapy that harmonizes Doshas, strengthens Dhatus, and maintains visual acuity. This review provides an integrative conceptual framework for understanding the pharmacodynamic basis of Akshi Tarpana as an ocular rejuvenative therapy.
Ayurvedic Management of Opioid Withdrawal Symptoms (Ahiphena Vyasana) using Kaktinduk Vati and Mansayadi Choorna: A Case Study
Opioid Use Disorder (OUD), recognized in Ayurveda as Ahiphena Vyasana, represents a global public health crisis characterized by compulsory drug-seeking behavior, loss of control over intake, and the emergence of severe negative emotional and physical states upon cessation.
Face Forward: Redefining Aesthetic Dentistry with 3D Scanning Intelligence
The rapid evolution of digital technologies has significantly transformed dental practices, particularly in prosthetic and aesthetic treatments. While intraoral scanners and CAD/CAM systems are now standard tools, the integration of facial scanners marks a new frontier in digital dentistry. These devices capture detailed 3D representations of the face, offering valuable data for diagnosis, treatment planning, and patient communication.
Unraveling the Role of Luteolin from Avena Sativa in Alzheimer's Disease: Targeting Key molecular mechanisms and its Neuroprotective Effects.
Neurodegenerative diseases, marked by progressive neuronal dysfunction and loss, pose significant health challenges with glutamate accumulation contributing to neuronal cell death in conditions such as Alzheimer's disease. It is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss and behavioral impairments that disrupt daily activities. It's the most common form of dementia, accounting for 60-70% of cases. Alzheimer's disease involves the degeneration of brain tissue, including loss of nerve cells and reduced responsiveness to neurotransmitters. Amyloid plaques and neurofibrillary tangles composed of hyperphosphorylated protein contribute to neuronal degeneration. This study explores the neuroprotective potential of Avena sativa leaf extract and its major constituent, Luteolin, against glutamate-induced hippocampal neuronal cell death. Treatment with glutamate led to reduced cell viability, altered morphology, increased reactive oxygen species (ROS) and apoptosis in HT-22 cells. However, pre-treatment with Avena sativa extract and luteolin attenuated these effects, restoring mitochondrial function, decreasing mitochondrial superoxide, and preserving mitochondrial morphology. Notably, luteolin inhibited excessive mitophagy by reducing lysosomal activity. Furthermore, luteolin's neuroprotective effects were associated with the activation of mTORC1, which attenuated glutamate-induced autophagy-mediated cell death. These findings highlight the potential of A.sativa and Luteolin as neuroprotective agents, regulating autophagy and mitochondrial dynamics to inhibit glutamate-induced neurotoxicity. This study provides valuable insights into the therapeutic potential of Luteolin and A. sativa in mitigating neurodegenerative diseases.
Understanding the Essence of Recovery-Oriented Practice: A Scoping Review
This scoping review aimed to address the challenge mental health professionals face in implementing recovery-oriented practice due to the lack of clear guidelines and the narrow focus on individual practitioner-client interactions in existing definitions. To fill these gaps, the review developed a comprehensive framework for implementation at the practitioner, organizational, and community levels. A systematic literature search from 1993 to 2024, including gray literature and snowballing techniques, identified 106 sources, which were synthesized through thematic analysis. Six main themes with 20 sub-themes were found at the practitioner level, six themes with 10 sub-themes at the organizational level, and four themes with six sub-themes at the community level. The review underscores the need for a whole-systems approach, addressing interactions across all levels and offering practical strategies to guide recovery-oriented practices.
The Role Of Garbhasamskara In Pre-Conceptional Care And Fertility Enhancement: An Evidence-Based Review
Infertility is a pervasive global health challenge, impacting approximately 10–15% of couples worldwide, translating to an estimated 48 million couples affected globally. This condition precipitates significant physical, mental, and financial distress, often compounded by the high costs and invasive nature of modern Assisted Reproductive Technologies (ART). Modern medicine generally defines infertility as the inability to conceive after 12 months of regular, unprotected coitus. Ayurveda, however, conceptualizes infertility, or Vandhyatva, more broadly, encompassing difficulties in conceiving naturally, recurrent miscarriage (Garbhasrava), and stillbirths (Mrutvatsa).[i] The limitations and emotional toll associated with conventional treatments have led to a rising utilization of complementary and alternative medicine (CAM), with reports indicating that nearly 29% of couples seeking fertility treatment integrate a CAM modality. This trend underscores a clinical need for holistic, systemic preparatory approaches that address the root causes of reproductive dysfunction rather than solely focusing on symptomatic management or technological bypass. The Ayurvedic preparatory system, Garbhasamskara, offers such a paradigm.[ii] [i] (2008). Charaka Samhita (P. V. Sharma, Ed. and Trans.). Chaukhambha Orientalia. [ii] Dhawan, V., & Sharma, A. (2018). Yoga/meditation modulates oxidative stress and improved sperm transcripts in recurrent pregnancy loss. Indian Journal of Medical Research, 148(2), 220–229.
Understanding Compassion Fatigue and Its Contributing Factors Among Nurses: A Focus Group Discussion Approach”
Background: Empathetic and caring nurses, become the victims of the continuing stress of the overwhelming needs of the patients & their families, resulting in compassion fatigue. The aim of the study is to explore the factors leading to compassion fatigue among nurses at various levels in the selected private & government hospitals of Punjab, India. Materials and Methods: Qualitative approach was adopted where multiple focus group discussions were planned and conducted. The study was carried out among nurses from the selected private & government hospitals of Punjab. Thematic analysis, using the argumentative interactions approach was used. The consolidated criteria for reporting qualitative research (COREQ) guide were followed. Results: Workload, less salary, less resources, stress, partiality, salary issues, long working hours and other related factors were reported as having a negative influence on staff nurses working efficiency. Conclusion: Most of the institutions included in the present study, lacked basic facilities for the professional development and smooth running of work of staff nurses.
Spinal Anesthesia using Isobaric Ropivacaine with Fentanyl Versus Spinal Anesthesia using Isobaric Ropivacaine with Dexmedetomidine for Lower Abdominal Surgeries: A Prospective Observational Study
Background: Spinal anesthesia is widely used for lower abdominal surgeries due to its reliability, cost-effectiveness, and rapid onset. However, the limited duration of local anesthetics such as ropivacaine necessitates the use of adjuvants to prolong block and improve postoperative analgesia. Fentanyl, an opioid, enhances block quality but is associated with opioid-related side effects. Dexmedetomidine, a selective α2-adrenergic agonist, has shown promise as an intrathecal adjuvant with superior block characteristics and fewer complications. Objective: This prospective observational study compared the efficacy of intrathecal fentanyl versus dexmedetomidine as adjuvants to isobaric ropivacaine in patients undergoing lower abdominal surgeries. Methods: Eighty ASA I–II patients were randomized into two groups: Group RD (ropivacaine + dexmedetomidine, n=40) and Group RF (ropivacaine + fentanyl, n=40). Demographic variables, block onset, duration, hemodynamic changes, analgesic requirements, and side effects were recorded and analyzed. Results: Both groups were comparable in baseline characteristics. The onset of sensory (159.2±7.39 vs. 189.7±9.34 sec) and motor block (453.2±10.61 vs. 489.4±9.68 sec) was significantly faster in Group RD. The duration of sensory (191.8±4.81 vs. 135.8±3.22 min) and motor block (152.9±4.99 vs. 126.5±3.05 min) was significantly longer with dexmedetomidine. Time to first analgesic request was also prolonged in Group RD (265±71.4 vs. 203±35.6 min). Hemodynamic parameters were stable in both groups, with mild bradycardia more frequent in Group RD but easily managed. Adverse effects were minimal and comparable. Conclusion: Intrathecal dexmedetomidine as an adjuvant to isobaric ropivacaine provides faster onset, prolonged sensory and motor block, extended postoperative analgesia, and stable hemodynamics compared to fentanyl. Dexmedetomidine appears to be a superior alternative for lower abdominal surgeries.
“Nephrectomy unmasked: A nephrectomy case series through histopathology and hurdles”
Nephrectomy remains a cornerstone procedure in the management of various renal pathologies, both benign and malignant. This case series emphasizes the unusual pathological entities and intraoperative complexities faced during nephrectomy. This case series aims to analyse the clinical indications, intraoperative findings, postoperative outcomes, and complications among patients who underwent nephrectomy at our hospital over the past 3 months. Materials and Methods: We have done retrospective observational study of 15 patients who underwent nephrectomy for both benign and malignant conditions between June 1, 2025 and August 30, 2025 at Department of Urology – at our hospital. We had collected socio-demographics data, clinical details (presenting symptoms, Preoperative CT scan findings, site of disease), intraoperative findings (operative time, blood loss, surgical approach, intraoperative complications), postoperative complications, mean hospital stay duration and histopathology report. We have done follow up of patient for 3 months postoperatively. Results: Among 15 patients (mean age-48.8 years), 9 patients (60%) underwent surgery for benign indication and 6 patients (40%) underwent surgery for malignant disease. A total of 8 patients (53.3%) underwent surgery with laparoscopic approach and 7 patients (46.7%) were underwent surgery with open approach (3 patients were converted to open surgery. Mean operative time was 160 minutes with average blood loss of 110 ml. Mean hospital stay was 4.2 days (range 3-9 days). Post operative wound infection was seen in 2 patients. We had discussed cases with xanthogranulomatous pyelonephritis, communicating ruptured hydatid cyst, mixed epithelial and stromal tumour, leiomyosarcoma of kidney, renal transitional cell carcinoma in nonfunctioning pyonephrotic kidney. We have managed two cases of duodenal perforation occurring intraoperatively during right nephrectomy Conclusion: Even in the minimally invasive era, open nephrectomy retains a vital and irreplaceable role. In our experience, judicious and patient-centered decision of timely conversion to open surgery ensures safety, complete disease control and favourable perioperative outcomes. In the current era, open nephrectomy continues to complement minimally invasive approaches rather than compete with them.
Role of speech language pathologist in Brain Awake Surgery: Enhancing Functional Outcomes and patient safety
Awake brain surgery, particularly awake craniotomy, has emerged as a critical neurosurgical technique aimed at maximizing tumor resection while preserving essential cortical functions, especially language and speech. Speech-Language Pathologists (SLPs) play a pivotal role in ensuring intraoperative functional mapping, patient cooperation, and postoperative rehabilitation. This paper reviews 32 clinical studies and case reports published between 2010 and 2024, highlighting the involvement of SLPs across the surgical timeline. Findings indicate that intraoperative language mapping conducted by SLPs reduced postoperative language deficits by approximately 38% and improved functional recovery rates by 42%. In centers with established SLP protocols, patient-reported satisfaction scores averaged 4.6 out of 5, and intraoperative complication rates related to speech disturbances were reduced from 27% to 12%. SLPs contributed significantly through preoperative cognitive-linguistic assessments, real-time language monitoring during cortical stimulation, and individualized post-surgical therapy plans. Their involvement not only safeguarded functional language outcomes but also contributed to reduced anxiety and enhanced patient safety. These findings emphasize the indispensable role of SLPs in awake neurosurgical procedures and advocate for their standardized inclusion in multidisciplinary teams to optimize neurofunctional outcomes and psychiatric rehabilitation.
Formulation of Herbal Mouth Wash using Psidum Guajava, Ocimum sanctum and Cinnamomum Verum Extract
Medicinal plant or herbs are considered to have rich source of ingredients which can be used in drug development. The formulation of herbal mouthwash is a natural approach to oral hygiene that utilizes plant-based ingredients to create a safe and effective mouthwash. Herbal mouthwash is intended to provide a range of benefits, including anti-bacterial, anti-inflammatory, and anti-plaque effects, as well as freshening breath and promoting healthy gums and teeth. The formulation of herbal mouthwash offers an alternative to chemical-based oral hygiene products that can sometimes cause irritation and sensitivity. With the growing interest in natural remedies and alternative health practices, the formulation of herbal mouthwash offers a promising solution for those seeking a more natural approach to oral hygiene. The main objective of this literature work is to prepare and evaluate a herbal mouthwash and check its effectiveness against microorganisms of oral cavity. The prepared mouthwash was evaluated against pathogens and was found effective for controlling and demolishing microbial growth in mouth. Further physiochemical properties were tested for mouthwash and it possesses a good antibacterial activity. Next, studies on physical evaluation, pH measurement, stability, viscosity and antibacterial activity were conducted.
Experimental Evaluation of Colorized Gross Anatomy Specimens as Teaching Aids in Laboratory and Museum Settings.
Background: Traditional gross anatomy education relies on preserved specimens, which often lose their natural color and make it difficult for students to clearly identify structures. To address this, colorized specimens enhanced with dyes or pigments have been introduced to improve visual clarity and learning engagement. While visually appealing and increasingly used in labs and museums, there is limited experimental evidence on their actual educational effectiveness. Objective: This study aims to evaluate the educational effectiveness of colorized gross anatomy specimens compared to non-colorized counterparts in enhancing anatomical understanding, student engagement, and information retention among medical and allied health science learners. Methods: in their study six anatomically distortion-free specimens from arterial embalmed cadavers were chosen from the department of anatomy. Results: Students in the colorized specimen group scored significantly higher on identification and retention tests (p < 0.05). They also reported improved clarity, greater engagement, and higher satisfaction. Qualitative feedback highlighted the specimens’ usefulness in achieving core anatomical competencies, particularly in visually guided learning environments such as museums and static displays.
Problematic Smartphone Use And Its Psychosocial Correlates: A G-Deeg–Based Paradigm Proposal
Background: The deep embedding of smartphones into everyday life has intensified debates about their links with psychological well-being and social functioning. Much of the literature reports small, context-sensitive associations between technology use and mental health indices; the magnitude and direction vary by use characteristics (e.g., passive social comparison, notification intensity), timing (especially late-night use), and individual susceptibilities (e.g., FoMO, impulsivity) [1, 2, 3, 4, 5, 6, 7, 8]. Objective: We conceptualize Problematic Smartphone Use (PSU) not as a standalone diagnosis but as a risk syndrome at the intersection of loss of control, tolerance/withdrawal-like patterns, and salient functional impairment. We integrate evidence within a multilayered framework (developmental, digital-design, emotional/psychological, social/environmental, biological) [9, 10, 11]. Methods: We narratively synthesize longitudinal/panel/EMA studies, systematic reviews and meta-analyses, and selected neuroimaging evidence published between 2013 and 2024 [12, 1, 13, 14, 15, 16, 17]. Findings (synthesis): (i) Average associations are small; however, context-sensitive large effects can emerge via sleep disruption, high-intensity notification architectures, and FoMO/emotion-regulation difficulties [12, 18, 19]. (ii) Neuroimaging studies note striatal–prefrontal differences in at-risk subgroups, with limited causal inference [20, 14]. (iii) Digital therapeutics yield small-to-moderate benefits for depression/anxiety; human support and measurement transparency appear to enhance effects [17, 21, 22]. Conclusions: Moving beyond “addicted everywhere for everyone,” PSU should be approached through functional impairment and context-based clinical decisions. At school/work, phone-free windows and notification diets are advisable; in clinics, stepped-care and preferably human-supported digital interventions are recommended. Future work should prioritize causal mapping through self-report–log–EMA triads, preregistered RCTs, and longitudinal neuroimaging [1, 13, 4].
Raktamokshana through Siravedha: A Critical Review of Mechanism, Utility, and Clinical Applications
Raktamokshana is a key procedure in Ayurvedic parasurgery, involving therapeutic bloodletting for Raktaja roga (blood-born disorders) and other disorders with impaired Rakta Dhatu and Pitta Dosha. Of the Raktamokshana methods, Siravedha (venepuncture) is defined as "Ardhachikitsa" (half the treatment) in Shalyatantra due to its efficiency and specificity. This review article summarizes the action, clinical uses and examination of Siravedha using Ayurvedic classical texts such as Sushruta Samhita, and contemporary scientific studies. The review examines physiological and biochemical processes relative to Siravedha use, clinical outcomes of the procedure for various conditions, contemporary scientific implications of these conditions, and obstacles to integration of the Siravedha procedure into contemporary clinical health practice. Additionally, this review proposes future research directions to help modernize the practice of Siravedha, especially in integrating Siravedha into clinical practice and further validating its clinical use.
Harnessing Costus Pictus D. For Sustainable Tio₂ Nanoparticles: Antimicrobial And Larvicidal Efficacy Unveiled
The present study explores the green synthesis, physicochemical characterization, and biomedical applications of biosynthesized TiO2 NPs using leaf extract of Costus pictus D. The synthesized TiO2 NPs were characterized through several techniques, including UV- Visible spectroscopy, photoluminescence (PL) analysis, HR-TEM, and DLS. UV-Vis spectroscopy revealed a distinct absorbance maximum at 313 nm, with an estimated energy bandgap of 3.24 eV, which was further supported by PL spectral analysis. Furthermore, Photoluminescence analysis indicated the occurrence of structural imperfections, including oxygen vacancies and self-trapped excitons, which influence the photonic behavior of the nanoparticles. HR-TEM revealed a uniform spherical morphology with an average particle size of 21 nm. In contrast, DLS measurements indicated a significantly larger hydrodynamic diameter of 657 nm, attributed to the inclusion of bio-capping agents. The moderate zeta potential of -6.47 mV suggests a reasonable level of colloidal stability. The antibacterial efficacy of the TiO2 nanoparticles was evaluated on both Gram-positive and Gram-negative bacteria, with Bacillus pumilus and Bacillus subtilis showing the greatest sensitivity. Notably, antifungal activity was determined to be particularly effective against Aspergillus niger. At the same time, larvicidal assays demonstrated significant mortality rates in Aedes aegypti and Culex quinquefasciatus larvae, increasing proportionally with the concentration of the treatment. These findings underscore the multifunctional capabilities of Costus pictus- mediated TiO2 nanoparticles as eco-friendly antimicrobial and larvicidal agents, emphasizing their promising applications in biomedicine and environmental health.
A Comparative Study of Bipolar I and Bipolar II Disorder: Clinical Features and Treatment Outcomes
Bipolar I and Bipolar II disorders, though both situated within the bipolar spectrum, are distinguished by significant differences in clinical presentation, course of illness, and psychosocial consequences. Bipolar I is characterized by manic episodes, often requiring hospitalization, whereas Bipolar II is characterized by recurrent depressive episodes and hypomania, leading to persistent functional impairment and underdiagnosis. The study explores these clinical distinctions and evaluates their implications for psychiatric rehabilitation and recovery-oriented care. It examines pharmacological outcomes alongside evidence-based psychosocial interventions such as cognitive-behavioral therapy, interpersonal and social rhythm therapy, psychoeducation, and peer-led recovery programs. Individualized strategies are prioritized, and Bipolar I usually requires a more structured crisis intervention and functional reintegration plans. In contrast, Bipolar II responds better through long-term administration of psychotherapy and motivational encouragement. The role of community-based mental health services (containing assertive community treatment, supported employment, and transitional housing) is covered within the dynamics of gaining autonomy and a better quality of life. CHIME (Connectedness, Hope, Identity, Meaning, Empowerment) is introduced as a basis of the self-recovery model. At the systems level, it is noted that integrated care, workforce development/maturation, and policy alignment are crucial elements for achieving equity in accessibility and outcome monitoring. The research highlights the importance of subtype-sensitive individualized rehabilitation models that would not only be able to stabilize a patient in the clinical sense but would also allow people to successfully recover both on a long-term basis and in terms of functionality overall.
“Managing the Silent Surgical Mimic : Evidence -Based Case Studies in Homeopathy”
Pseudo-surgical cases often mimic acute surgical emergencies yet lack the full range of diagnostic indicators. The scarcity or vagueness of symptoms complicates clinical decision-making and may lead to unnecessary surgical interventions. Such presentations require careful assessment, as the paucity of characteristic signs creates diagnostic ambiguity. Homeopathy, with its emphasis on individualized treatment and sensitivity to subtle symptom expressions, offers a distinctive therapeutic approach in these scenarios. This study presents evidence-based case analyses of patients who exhibited minimal or incomplete clinical signs suggestive of surgical pathology. True surgical emergencies were excluded through standard diagnostic protocols, following which individualized homeopathic remedies were prescribed. Each case was closely monitored for symptomatic response, clinical progression, and safety outcomes. Findings revealed that even in the absence of marked symptoms, carefully selected remedies produced significant clinical improvement and prevented surgical intervention. These outcomes underscore the value of detailed case-taking, recognition of subtle indications, and evidence-based reasoning in remedy selection. Thus, Evidence-based homeopathy demonstrates a meaningful role in managing pseudo-surgical cases with limited or non-specific symptomatology. By emphasizing individualization and rigorous diagnostic exclusion, homeopathy provides a safe, effective, and non-invasive therapeutic alternative that can reduce unnecessary surgical procedures.
Holistic Assessment of Individualized Homeopathic Therapies in the Management of Cervical Spondylosis: A Prospective Quasi-Experimental Study at a Tertiary Care Centre
Cervical spondylosis—a prevalent cause of chronic neck pain and functional disability—was studied in 100 adults at a tertiary care centre over 18 months. Participants were treated with individualized homeopathic therapy based on miasmatic analysis and constitution, using rigorous assessment tools: Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Universal Goniometer. Substantial improvements in pain, mobility, and disability profiles were statistically validated. This elaborated report supports the scientific integration of homeopathy for chronic musculoskeletal disorders.
Upanaha Swedana in Ayurveda: Classical Insights, Clinical Evidence, and Modern Correlations
Upanaha Swedana, a classical Ayurvedic poultice fomentation therapy, has been widely used in the management of Vata Vyadhis, particularly Sandhigata Vata (osteoarthritis). This review consolidates data from classical Ayurvedic texts [1–6], published clinical trials [7–11], case studies [12–14], and modern reviews [15–18]. Major formulations such as Koladi, Kolakulathadi, Kottamchukkadi, Godhumadi, Shatapushpadi, and Salavana are described along with their pharmacological rationale. Clinical evidence demonstrates consistent relief in pain, stiffness, and swelling [7–14]. Mechanisms are interpreted through Ayurvedic principles (ushna, snigdha, guru, sthira gunas) [1–3] and modern correlates (thermotherapy, phytochemistry, compression, neuromodulation) [15–18].
Palliative care in patients with non-oncological diseases: Challenges for nursing
: Patients with advanced non-oncological chronic diseases, such as heart failure, COPD, dementia, and chronic kidney disease, have complex palliative care needs that are often unrecognized and inadequately addressed. These gaps in care compromise their quality of life and symptom control. Objective: This systematic review aims to synthesize the available evidence on the delivery of palliative care in non-cancer patients and highlight the contributions and challenges faced by nursing professionals in these contexts. Methods: A comprehensive search was performed across PubMed, Scielo, and Web of Science databases using Boolean operators. Inclusion criteria included peer-reviewed articles from 2010 to 2025 addressing palliative care in non-oncological populations. Exclusion criteria included studies focused solely on cancer, editorials, and protocols. Seventeen articles were selected and analyzed. Results: The findings reveal significant barriers to access, lack of early integration, limited institutional protocols, and insufficient nursing training. However, the evidence underscores the pivotal role of nurses in symptom management, patient-centered communication, and care coordination. Conclusion: Enhancing palliative care in non-cancer conditions requires early intervention, standardized protocols, and greater institutional support. Strengthening nursing education and integrating multidisciplinary collaboration are key strategies to improve patient outcomes in this vulnerable population.
Stress-Induced Menstrual Irregularities In Indian Working Women: A Homoeopathic Perspective
Menstrual irregularities (cycle length changes, oligomenorrhea, amenorrhea, polymenorrhea, menorrhagia and dysmenorrhea) are common and can impair productivity and quality of life among working women. Psychological stress-particularly chronic work-related stress-disrupts the hypothalamic–pituitary–gonadal (HPG/HPO) axis via the hypothalamic-pituitary–adrenal (HPA) axis and is a significant, often under-recognized contributor to menstrual dysfunction. In India, studies indicate a high prevalence of menstrual complaints among working women and link these to stress and workplace factors. Complementary therapies, including individualized homoeopathy, are used by some women for menstrual complaints; however, the evidence base is mixed with few high-quality randomized controlled trials and systematic reviews showing inconclusive results. This review synthesizes physiological mechanisms, epidemiological evidence (with emphasis on working women and Indian data), and its homoeopathic management as integrated clinical approach.
Cultural Influences on Chronic Low Back Pain: A Systematic Review with Indian Perspectives
Background: Chronic low back pain (CLBP) contributes significantly to global disability, with prognostic models and clinical prediction rules (CPRs) aiding outcome prediction and treatment tailoring. Adherence to physiotherapy is critical but varies culturally, particularly in India, where kinesiophobia and joint family systems influence outcomes. Objective: To synthesize evidence on prognostic models, CPRs, physiotherapy interventions, and adherence in adults with CLBP (2000–2025, with relevant 1997–1999 studies), emphasizing Indian perspectives. Methods: This PRISMA-compliant systematic review searched PubMed, Cochrane Library, ClinicalTrials.gov, and Google Scholar. Studies on CLBP prognosis, CPRs, or adherence in adults were included. Data extraction covered study characteristics, cultural factors, outcomes, and models/adherence. Narrative synthesis and subgroup analyses compared Indian and global contexts. Risk of bias was assessed using NOS, RoB 2, AMSTAR-2, and CASP. Results: From 470–520 records, 43 studies were included, with 11 prioritized: 5 on prognostic models/CPRs, 3 on adherence, and 3 on both. Mukasa and Sung (2020) (Mukasa & Sung, 2020) reported robust models for LBP onset (Harrell’s C 0.812) and recurrence (0.916). Kongsted et al.(2016) (Kongsted et al., 2016)showed low prognostic accuracy (AUC 0.50–0.61). Indian studies (Vaidya et al., 2023) highlighted kinesiophobia as an adherence barrier. The Enhanced LBP Risk Score Calculator integrates risk prediction, subgrouping, and cultural factors. Conclusion: Prognostic models and adherence strategies are promising but require validation, especially in India.
When Addiction Hits Home: A Cross-Sectional Study of Family Burden in Alcohol Abuse Based on FBIS
Background: Caring for a person with alcohol dependence places a significant emotional, physical, and social burden on caregivers. These individuals often face stigma, disrupted family dynamics, and ongoing stress as they support their loved ones through cycles of addiction and relapse. Unlike other chronic conditions, alcohol use disorders present unique caregiving challenges due to their unpredictability and long-term impact. Despite this, limited research exists on caregiver burden in such contexts. This study aims to assess the level of burden experienced by caregivers and explore the sociodemographic and clinical factors influencing it. Methods: A cross-sectional study was conducted involving 142 family members of individuals with alcohol use disorders. Participants were recruited from three de-addiction centres in Kanyakumari district—Puthuvasantham Centre, Jesuit Ministry, and New Life Centre —as well as from selected community settings. Data were collected using the Family Burden Interview Schedule (FBIS). Results: Mean burden scores indicated high disruption in various areas of family life: routine activities (194±13.16), leisure (185.25±13.93), interactions (196±19.68), physical health (91.5±9.5), mental health (130.5±72.5), and subjective burden (1.54±0.53). Conclusion: This study reveals the substantial and multidimensional burden carried by caregivers of individuals with alcohol dependence. The findings call for urgent implementation of structured support systems and evidence-based interventions tailored to caregivers’ needs. Recognizing caregiver distress as a public health priority is essential—not only to safeguard their mental and physical well-being, but also to strengthen the overall success of addiction treatment and recovery efforts. Sustainable policy frameworks must be developed to bring long-overdue visibility and resources to this often overlooked, yet critical, group.
Ayurvedic Management of Chronic Vataj Pratishyaya (Allergic Rhinitis) Using a Combined Regimen of Nidigdhika Avaleha and Shadbindu Taila Nasya: A Case Study
Background: Allergic Rhinitis (AR) is a pervasive global disorder of the upper respiratory tract, characterized by IgE-mediated hypersensitivity reactions. In Ayurveda, this condition aligns symptomatically and pathogenically with Vataj Pratishyaya, involving the vitiation of Vata and Kapha and localization of pathology in the Pranavaha Srotas (respiratory channels). Chronic forms of the disease necessitate a comprehensive, multimodal approach that targets both localized nasal symptoms and systemic root causes, such as compromised digestive fire (Agni) and toxin accumulation (Ama). [i],[ii] Case Presentation: A 22-year-old female patient presented with chronic Vataj Pratishyaya, manifesting as severe sneezing, rhinorrhoea, nasal congestion, and nasal itching persisting for 2–3 years. Initial clinical assessment yielded a Total Nasal Symptom Score (TNSS) of 11 out of 12. Objective laboratory markers indicated an inflammatory and allergic state, with an Absolute Eosinophil Count (AEC) of 1.08×103/μL and an Erythrocyte Sedimentation Rate (ESR) of 32 mm/Hr. Intervention: The subject was enrolled in a 30-day single-arm exploratory study. The patient received a combined therapeutic regimen consisting of Nidigdhika Avaleha (6g, orally, twice daily) and Shadbindu Taila Nasya (2 drops bilaterally, twice daily). Results: The intervention resulted in significant clinical remission. The subjective Total Nasal Symptom Score (TNSS) decreased substantially, moving from a baseline of 11 to a post-treatment score of 4, reflecting 63.6% symptomatic relief. Concurrently, objective anti-allergic and anti-inflammatory effects were recorded: the Absolute Eosinophil Count (AEC) decreased by 16.67% (from 1.08×103/μL to 0.90×103/μL), and the Erythrocyte Sedimentation Rate (ESR) decreased by 21.87% (from 32 mm/Hr to 25 mm/Hr). Conclusion: The synergistic application of systemic Nidigdhika Avaleha and local Shadbindu Taila Nasya provides a highly effective therapeutic approach for chronic Vataj Pratishyaya. The regimen not only alleviates cardinal symptoms but also demonstrably modulates underlying allergic inflammation, confirming its potential for holistic management.
Awareness and Practice of Ultrasound-Guided Procedures among Junior Doctors: A Cross-Sectional Study
Background: Ultrasound-guided (USG) procedures have revolutionized clinical practice by enhancing accuracy, improving patient safety, and reducing complication rates. Despite growing evidence supporting its utility, the extent of awareness and practice among junior doctors remains unclear in many healthcare settings. Objective: To assess the level of awareness and practice of ultrasound-guided procedures among junior doctors in a tertiary care teaching hospital and to identify perceived barriers to their utilization. Methods: A cross-sectional questionnaire-based survey was conducted among 150 junior doctors (interns and residents). The tool assessed demographics, awareness, practice, and barriers to ultrasound use. Data were analyzed using descriptive statistics and chi-square tests (SPSS v25). Results: Most participants (94%) had heard of ultrasound-guided procedures, and 78% recognized its role in improving safety. However, only 32% had received formal training, and just 25% reported independently performing central venous cannulation under ultrasound guidance. Familiarity with international guidelines was low (24%). Lack of training (54%), limited machine availability (38%), and inadequate supervision (28%) emerged as major barriers. Conclusion: Junior doctors demonstrated high theoretical awareness but limited practical exposure to USG procedures. Expanding structured training, ensuring machine availability, and fostering mentorship are essential to bridge this knowledge–practice gap and enhance patient outcomes.
Effectiveness of Vaccination Programs in Reducing the Incidence of Pediatric Meningitis: A Systematic Review
Pediatric meningitis is a life-threatening condition caused by inflammation of the protective membranes covering the brain and spinal cord, often resulting from bacterial or viral infections. Children, particularly infants and young children, are among the most vulnerable populations due to their underdeveloped immune systems. The disease poses a significant global burden, leading to high morbidity, long-term neurological complications, and mortality, especially in low- and middle-income countries (Ohm et al., 2022).
Patient Satisfaction Level in OPD and IPD and Their Comparison
Background: Patient satisfaction is a key indicator of healthcare quality and reflects the effectiveness, accessibility, communication, and overall functioning of healthcare systems. Measuring satisfaction in both Outpatient Departments (OPD) and Inpatient Departments (IPD) provides insight into service gaps and areas needing improvement. Objectives: To assess patient satisfaction levels among OPD attendees. To assess satisfaction levels among IPD patients. To compare OPD and IPD satisfaction domains. Methods: A cross-sectional study was conducted at Government Medical College, Ayodhya, during November 2021. A total of 180 patients (OPD = 100; IPD = 80) were selected. A structured questionnaire assessed satisfaction across domains: registration process, waiting time, doctor interaction, staff behaviour, cleanliness, availability of medicines, and overall experience. Data were analysed using percentages and comparison charts. Results: Overall satisfaction was higher in IPD patients (82%) compared to OPD patients (67%). OPD dissatisfaction was mainly due to long waiting times (56%) and overcrowding. IPD dissatisfaction was mainly related to sanitation issues (18%) and delay in investigations (22%). Conclusion: IPD satisfaction was significantly higher than OPD satisfaction. Improving OPD waiting times, streamlining registration, and enhancing cleanliness in both areas may enhance patient experience.
Disclosing A Mental Illness When Returning To Work After Sickness Absence
As part of the RETURN study, a mixed-methods, multi-center, cluster-randomized controlled trial that surveyed inpatients with mental disorders in psychiatric units in the greater Munich area, it was our aim to gain a better understanding of individual disclosure experiences and their effects and consequences. We conducted 15 interviews with persons with mental disorders that had been hospitalized in psychiatric clinics and returned to their workplace afterwards. The participants showed individual disclosure strategies and viewed their decisions as highly situational. A main reason for non-disclosure was fear of negative consequences, whereas a common reason for disclosure was the level of trust. In all interviews, the importance of mental illnesses being recognized as equivalent to somatic illnesses was stressed. Supporting people in their disclosure decision is about decision-making and finding a way to deal with the outcome of the personal disclosure situation and thus feeling comfortable enough to return to the workplace. Employers should support this process by fostering an attitude that accepts mental illnesses and reduces prejudice and stigmatization.
Alcohol Dependence and Its Impact on Male Sexual Function: A Cross-Sectional Study
Background: Alcohol dependence is often linked with adverse effects on male sexual health. While alcohol may temporarily enhance sexual confidence or performance, chronic and excessive use leads to marked sexual dysfunction. Despite its clinical relevance, sexual health concerns are frequently overlooked in alcohol-dependent individuals, especially in India, where stigma and underreporting are prevalent. This study aimed to determine the prevalence and pattern of sexual dysfunction among men with alcohol dependence and examine its association with sociodemographic and clinical variables. Methods: A cross-sectional study was conducted in the Department of Psychiatry, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan. One hundred male patients aged 18–60 years diagnosed with alcohol dependence (ICD-10) were included. Sexual function was assessed using the Arizona Sexual Experience Scale (ASEX), and dysfunction was categorized as mild, moderate, or severe. Statistical analysis involved descriptive measures, the chi-square test, the independent t-test, and the Pearson correlation, with p < 0.05 considered statistically significant. Results: The prevalence of sexual dysfunction was 68%, with 24% mild, 30% moderate, and 14% severe cases. Erectile function (42%) and reduced sexual desire (35%) were the most affected domains. Dysfunction significantly correlated with longer alcohol use (>10 years, p < 0.01) and older age (>40 years, p < 0.05), but not with education or socioeconomic status. Conclusion: Sexual dysfunction is highly prevalent among alcohol-dependent men. Increasing age and prolonged alcohol use are key risk factors, warranting routine sexual health assessment in this population.
Clinical Evaluation of Vishmusthyadi vati and kalyank churna in the withdrawal of tobacco chewing addiction: a case study
Smokeless tobacco (ST) chewing addiction represents a substantial public health burden, particularly in India, necessitating effective withdrawal strategies. In Ayurveda, tobacco (Tamraparna or Nicotiana tabacum) is classified as a Sthavara Vanaspatij Visha (immobile plant poison). Chronic use and subsequent withdrawal induce a neurobehavioral syndrome characterized by the vitiation of Vata and Kapha Doshas and disturbance of the Manovaha Srotas. This report details the outcome of an Ayurvedic combined therapeutic regimen targeting this withdrawal pathology.[i], Case Presentation A 25-year-old male labourer, presented with a 5-to-6-year history of daily smokeless tobacco (Zarda) addiction. Initial assessment using the Nicotine Withdrawal Scale for Tobacco Chewing Addiction yielded a total score of 24, classifying the patient as suffering from Severe Withdrawal. Primary complaints included severe craving, anxiety, irritability, and difficulty in concentration. Intervention The patient was administered a combined regimen for a continuous period of 21 days as per the research protocol. The intervention comprised Vishmusthyadi Vati (1–2 Vati, orally, twice daily with lukewarm water after meals) and Kalyank Churna (3g, four times daily, administered specifically for chewing). Results Subjective clinical efficacy was highly significant. The total Nicotine Withdrawal Score decreased substantially from 24 (Severe) at baseline to 7 (Mild) at the end of the 21-day intervention, representing a 70.83% improvement in symptomatic relief. The primary end point patient unwillingness to consume tobacco was achieved. Objective assessments revealed metabolic shifts typical of the acute cessation phase, including increases in Total Cholesterol (120.9 to 152.2) and Triglycerides (111.6 to 131.2). Hematological markers (ESR, TLC) showed favorable minor reductions. Conclusion The synergistic application of the nervine tonic and antitoxic Vishmusthyadi Vati alongside the Deepana-Pachana and behavioral substitution agent Kalyank Churna proved highly effective in managing acute tobacco withdrawal symptoms. The regimen addresses both the Visha effects and the associated Vata-Kapha pathology. The results indicate a successful cessation strategy, though they mandate continued metabolic monitoring in the post-cessation phase.
Effectiveness Of Lifestyle Interventions In Preventing Metabolic Syndrome In Primary Care: A Systematic Review
Background: Metabolic syndrome (MetS) is a growing global health challenge strongly associated with increased risks of type 2 diabetes and cardiovascular diseases. Primary care plays a pivotal role in delivering preventive lifestyle interventions targeting modifiable risk factors. Objective: This systematic review aimed to synthesize contemporary evidence on the effectiveness of lifestyle interventions—focusing on diet, physical activity, and behavior change—delivered within primary care settings to prevent or reverse MetS in at-risk adults. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. Databases searched included PubMed, Scopus, Web of Science, Embase, and Google Scholar. Eligible studies were randomized controlled trials, cluster-RCTs, community trials, or systematic reviews/meta-analyses published in English from 2000 to 2025. Data extraction and risk-of-bias assessment were performed by independent reviewers. Results: Fifteen studies met inclusion criteria, comprising diverse populations and intervention formats. Findings consistently showed that structured lifestyle interventions reduced MetS incidence by 20–69% compared to usual care. Significant improvements were observed in weight, waist circumference, blood pressure, glucose, and dietary quality. Successful programs often used multi-component strategies, cultural tailoring, and group support. Conclusion: Lifestyle interventions delivered in primary care are effective, feasible, and cost-effective for preventing MetS. Embedding structured behavioral support and culturally adapted approaches can enhance implementation and sustainability.
"The Impact of Pharmacogenetics on Patient Response to Clopidogrel Post-Coronary Angioplasty: Systematic Review"
Background Clopidogrel is widely used post-percutaneous coronary intervention (PCI), but patient response varies significantly due to genetic polymorphisms, particularly in the CYP2C19 gene. Loss-of-function alleles reduce the conversion of clopidogrel to its active form, compromising its efficacy and increasing cardiovascular risks. Objective To systematically review the impact of CYP2C19 polymorphisms on clopidogrel response and cardiovascular outcomes in adult PCI patients. Methods A PRISMA-guided systematic review was conducted using PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Studies included were published from 2000 to 2025, involved human adults post-PCI on clopidogrel, and reported outcomes based on CYP2C19 genotype. Data were synthesized narratively due to study heterogeneity. Results Fifteen studies involving over 20,000 patients were included. CYP2C19 LOF allele carriers had increased rates of stent thrombosis, MACE, and reduced platelet inhibition. Genotype-guided therapy (e.g., ticagrelor or high-dose clopidogrel) significantly improved clinical outcomes in LOF carriers. Conclusion Pharmacogenetic testing for CYP2C19 variants can optimize clopidogrel therapy post-PCI. Incorporating genotype-guided treatment strategies enhances safety and efficacy, supporting the case for precision medicine in cardiology.
Health-Related Quality of Life Post Hip & Knee Arthroplasties
Total arthroplasties are commonly performed orthopedic procedure with an increasing rate of utilization. Arthroplasties are Hip and knee osteoarthritis (OA) causes pain and the restriction of the movement of the affected joint and the worsening of the quality of life . The effective surgical treatment for OA is an arthroplasty. Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) have been shown to significantly decrease joint pain and improve joint movement. Furthermore, arthroplasty has shown general positive changes in the quality of life, not only in the improvement of operated hip and knee joints. Although there are number of studies evaluating patient outcomes after THR and TKR with respect to physical functioning and pain relief, relatively few studies have specifically evaluated changes in health-related quality of life (QOL). We reviewed a total of studies that evaluated changes in QOL after THR & TKR. Results of all studies were consistent in showing beneficial and often dramatic improvements in QOL after elective THR & TKR. These improvements were most likely to occur within the first 3 to 6 months of procedure.
Digital Epidemiology In Urban Health Monitoring: A Narrative Review Of Smart Technologies And Public Health Integration
Background: Digital epidemiology that is, the use of data generated by digital devices that has health-related content to infer health-related outcomes is becoming a central strategy for meeting complex urban health challenges. High rates of urbanisation lead to population density, mobility, and environmental pressures that can predispose cities to outbreaks of infectious disease, burdens of chronic illness, and environmental health threats. Smart tools such as mobile health apps, wearables, Internet of Things (IoT)–based sensors, and artificial intelligence (AI)–based analytics allow real-time monitoring and early warning and targeted interventions, offering an unprecedented opportunity to improve public health promotion efforts in urban settings. Materials and Methods: For a narrative review in PubMed, Scopus and Web of Science since 2010 up to 2024. It encompassed keywords such as "digital epidemiology," "urban health," "smart technologies," "mHealth," "IoT" and "public health informatics." Studies and reports pertaining to digital urban health monitoring tools and their integration into public health systems were included. We excluded rural health studies, non-digital interventions, and certain reports such as a non-peer-reviewed report. Results: The report finds an increasing emphasis on wearable devices to achieve continuous monitoring of biometrics, the use of mobile health apps to engage citizens, AI-driven analytics to drive predictive modelling, combinations of IoT-based environmental sensors to monitor pollution and climate, and the use of GIS mapping for spatio-temporal disease tracking. Many smart city projects have successfully proved the value of integrating with public health systems, enabling faster outbreak detection, better chronic disease management, and enhanced community-based health interventions. Conclusion: Smart technologies are increasingly used for urban and health monitoring, and integrating such technologies into public health policies may not only enable accessing many such systems but also facilitate a transition from reactive to proactive urban health monitoring systems. This transition encourages prevention of diseases earlier, an evidence-based approach on policies, along with more durable and healthier urban populations.
Dexmedetomidine and Melatonin for Postoperative Sleep Disturbances and Delirium in Neurosurgical ICU: An Observational Study of 40 Patients
Background: Postoperative sleep disturbances and delirium are frequent in neurosurgical ICU patients, leading to agitation, sympathetic surges, raised intracranial pressure, and prolonged ICU stay. Pharmacological strategies remain underexplored. Methods: This prospective observational study was conducted at SKIMS Soura Srinagar between August 2024 and July 2025. Forty postoperative neurosurgical ICU patients with intracranial tumors who developed sleep disturbances and delirium were included. Patients were managed with either low-dose dexmedetomidine infusion (0.2–0.4 μg/kg/hr, no loading dose) or oral melatonin (3–6 mg at bedtime). Primary outcomes were sleep quality and delirium resolution; secondary outcomes were adverse effects and ICU stay. Results: Twenty patients received dexmedetomidine and twenty received melatonin. Dexmedetomidine improved nocturnal sleep continuity in 85% and resolved delirium in 90% of patients within 24 hours, but was associated with mild bradycardia in 2 patients. Melatonin improved sleep–wake rhythm in 80% and resolved delirium in 75% of patients within 48 hours, with no haemodynamic side effects. Mean ICU stay was 4.2 ± 1.1 days in the dexmedetomidine group and 4.6 ± 1.3 days in the melatonin group. Conclusion: Both dexmedetomidine and melatonin are effective in managing postoperative sleep disturbances and delirium in neurosurgical ICU patients. Dexmedetomidine provides rapid control of agitation and sleep induction, whereas melatonin restores circadian rhythm with excellent safety.
Prevalence and Antimicrobial Resistance Pattern of Staphylococcus aureus in the Kanpur Nagar.
Background: Staphylococcus aureus is a significant human pathogen responsible for a range of infections, with increasing concern due to rising antimicrobial resistance, particularly Methicillin-Resistant S. aureus (MRSA). This study aimed to determine the prevalence and antimicrobial resistance pattern of S. aureus in Kanpur Nagar. Methods: A total of 309 clinical samples were collected from patients across various healthcare settings. Isolation and identification of S. aureus were performed using standard microbiological methods. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disc diffusion method following CLSI guidelines. Results: The overall prevalence of S. aureus was 15.7%, with the highest recovery from nasal swabs, pus/wound samples, and throat swabs. MRSA was present across all age groups, most commonly in the 25–44 age group, though no significant association with age or gender was found. Antibiotic sensitivity was highest to vancomycin (86%), linezolid (79%), and gentamicin (70.6%), while penicillin (5.3%) and ampicillin (16%) showed high resistance levels. Conclusion: The findings indicate a moderate burden of S. aureus in the region, with notable resistance to first-line antibiotics. Regular antimicrobial surveillance, judicious antibiotic use, and strict infection control policies are essential to limit the spread of MRSA and other resistant strains.
The Innovative Strategies Beyond Traditional Lectures And Practical Courses Advancing Pharmacology Education
Aims: The study aims to compare the effectiveness of traditional and innovative educational practices in pharmacology education among 2nd Professional MBBS students, focusing on enhancing student engagement, knowledge retention, and the development of critical clinical skills. Methods and Material: A prospective questionnaire-based study was conducted at K D Medical College & Hospital, Mathura, involving 300 students divided into control (traditional methods) and experimental (innovative methods) groups. The control group received lectures and lab sessions, while the experimental group engaged with flipped classrooms, collaborative learning, and interdepartmental integration. Data collection included pre-and post-test assessments, surveys, focus groups, and classroom observations. Quantitative data were analyzed using T-tests and ANOVA, and qualitative data were thematically analyzed using SPSS Version 26. Ethical approval was obtained, and participant confidentiality was maintained throughout the study. Results: The experimental group demonstrated significantly higher knowledge acquisition, scoring on average 25 points more than the control group. Additionally, the experimental group had a 90% attendance rate compared to 75% in the control group, indicating a 15% increase in attendance due to the intervention. Satisfaction levels were also higher in the experimental group, with average scores ranging from 4.5 to 4.9 out of 5, compared to 3.0 to 3.4 in the control group. The findings further indicated that the use of innovative teaching strategies led to improved student participation and interaction. Benefits highlighted in student journals included enhanced visualization, social learning, and applied knowledge. Conclusions: In Conclusion, Innovative teaching methods such as games, case discussions, and role-playing were more effective than conventional lecturing in enhancing knowledge acquisition, motivation, attendance, and course satisfaction in pharmacology.
Wounds That Speak: Exploring Childhood Trauma and Self-Injury in Patients with Generalized Anxiety Disorder
Anxiety disorders affect up to 20% of adults annually, with Generalized anxiety disorder being among the most prevalent. The defining characteristics of generalized anxiety disorder are persistent feelings of stress and dread, along with exaggerated, irrational and perpetual worry over routine matters. This excessive worry often spans concerns about the future, family, health, or finances, and is difficult to manage, frequently accompanied by vague physical and psychological symptoms.1,2 The weighted prevalence rates observed was 5.8% for GAD in accordance with the Indian research.
Supporting attunement in the parent-child relationship through dance movement therapy: A pilot study on furthering the global development of neonatal intensive care unit graduate patients in India
Dance Movement Therapy (DMT) is at a nascent stage in India and is not a service accessible in the perinatal and paediatric Neonatal Intensive Care Units (NICUs). DMT can provide interventions to meet an individual’s personal, physical, emotional, biological, neurodevelopmental, and interpersonal needs. This study proposes that all families and infants could benefit from the supportive intervention DMT provides to the parent-child dyad. Care in a NICU only concerns itself with the physical milestones of the child and does not acknowledge the mental and emotional condition of the child. Each child who has stayed in the NICU has experienced separation from the mother (their primary caregiver). Most doctors, nurses, and other caregivers focus on infant irritability, poor sleep, feeding, or pain.
“Effect of Myoinositol in Lipid Profile and Insulin Resistance in PCOS Patients.”
Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with insulin resistance, dyslipidaemia, and increased cardiovascular risk. Myoinositol, an insulin-sensitizing agent, has shown promise in managing PCOS-related metabolic disturbances, but its effects on lipid profiles and insulin resistance across diverse PCOS phenotypes require further exploration. Objective: This study aimed to evaluate the effects of myoinositol supplementation on lipid profiles, insulin resistance, fasting blood sugar, body mass index (BMI), waist-to-hip ratio (WHR), and blood pressure in women with PCOS. Methods: A prospective interventional study was conducted on 73 young women (mean age 21.15 ± 3.32 years) diagnosed with PCOS based on Rotterdam 2003 criteria. Participants received myoinositol supplementation for three months. Baseline and post-treatment assessments included fasting blood sugar, lipid profiles (triglycerides, cholesterol, HDL, LDL, VLDL), fasting insulin, HOMA index, BMI, WHR, and blood pressure. Statistical analyses were performed using IBM SPSS Statistics (Version 29), with paired t-tests and Mann-Whitney U tests for continuous variables and chi-square tests for categorical variables. Results: Myoinositol significantly reduced LDL cholesterol (110.82 ± 27.36 to 98.31 ± 21.32 mg/dl, p=0.0423), increased HDL cholesterol (39.06 ± 7.61 to 42.83 ± 7.66 mg/dl, p=0.0491), decreased BMI (26.04 ± 1.86 to 24.26 ± 0.15, p<0.0001), and lowered systolic and diastolic blood pressure (p<0.0001). Trends toward improvement were observed in fasting insulin (14.81 ± 5.86 to 13.5 ± 4.98 µU/ml, p=0.3315), HOMA index (2.23 ± 0.78 to 2.0 ± 0.78, p=0.2354), triglycerides (134.46 ± 39.77 to 128.01 ± 31.75 mg/dl, p=0.4692), and VLDL (39.22 ± 17.07 to 33.98 ± 20.96 mg/dl, p=0.2696), though these were not statistically significant. No significant changes were noted in fasting blood sugar (p=0.4444) or total cholesterol (p<0.0001, slight increase). Conclusion: Myoinositol significantly improves lipid profiles, BMI, and blood pressure in PCOS patients, particularly those with moderate insulin resistance, supporting its role as a safe, non-pharmacological adjunct therapy. However, its impact on glucose homeostasis and insulin resistance appears modest in this cohort. Further randomized controlled trials are needed to confirm these findings and optimize therapeutic strategies for PCOS management.
“A Cross-sectional Study to Assess the Frequency of Phantom Pattern and its Association with Smartphone Dependence and Perceived Stress among Nursing Students, SGT University, Gurugram (Haryana)”
Background: Phantom Vibration Syndrome (PVS) and Phantom Ringing Syndrome (PRS) are perceptual illusions of phone alerts without external stimuli. With widespread smartphone use, these phenomena have emerged as significant concerns among students. Objective: To assess the prevalence of phantom vibration and ringing patterns, smartphone dependence, and perceived stress, and examine correlations among them in nursing students. Methods: A cross-sectional quantitative study was conducted among 326 nursing students at SGT University using non -randomized convenience sampling. Standardized tools included the Smartphone Addiction Scale–Short Version (SAS-SV) and semi-structured questionnaires assessing phantom vibration and ringing. Descriptive and inferential statistics were applied using SPSS. Results: Of participants, 27.6% were classified as smartphone addicted, 6.1% had a high likelihood of phantom ringing, and 7.98% reported high impact of phantom vibration on stress. Significant positive correlations were found between smartphone addiction and vibration syndrome (r=0.557), and weaker correlations between smartphone addiction and phantom ringing (r=0.366). Conclusion: Phantom patterns are prevalent among nursing students, closely associated with smartphone dependence and perceived stress. Educational interventions and mental health awareness are recommended to mitigate these effects.
Light Treatment for PTSD: A Systematic Review
Background and objectives: Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by a terror-striking event, causing flashbacks, intrusive thoughts or images, nightmares, sleep disturbances, depressive symptoms, and anxiety. Light treatment has been identified as a possible alternative or adjuvant treatment for PTSD. The present study aims to systematically review the available evidence evaluating the effects of light treatment intervention on PTSD symptoms. Methods: A systematic search was conducted in PubMed, Scopus, Cochrane Library, Web of Science, PsycINFO and ClinicalTrials.gov registry up to February 2024. Controlled trials involving light treatment for PTSD were sought for the review of clinical effectiveness. Results: From 1,805 published and unpublished studies, five studies (n = 280) were included in this systematic review. Two studies used blue light treatment vs. placebo amber light treatment, one study used white bright light treatment compared to inactivated negative ion generator, a pilot trial delivered bright light treatment compared to a sham treatment, and another pilot trial delivered green bright light treatment compared to dimmed light treatment as an intervention for PTSD. Present data indicates favorable effects of blue light and bright light interventions for improving PTSD symptoms. Conclusions: It is becoming increasingly evident that light treatments are effective in treating PTSD. Nevertheless, more studies with greater statistical power are required to provide a solid foundation for recommending light treatment for management of PTSD.
Phytochemical Screening and Antimicrobial Activity of Schweinfurthia papilionacea (L.) BOISS
The aim of this study was to evaluate the antimicrobial activity of methanol and chloroform extracts of Schweinfurthia papilionacea against various microbial strains, including Pseudomonas aeruginosa, Staphylococcus aureus, Shigella flexneri, Escherichia coli, Salmonella typhi, and Aspergillus flavus. The phytochemical analysis of the extracts revealed a rich composition of bioactive compounds, including saponins, alkaloids, flavonoids, and phenolic compounds. The concentrations of the phytochemicals in the samples were varied, ranging from 0.2 to 0.5 mg/ml, and the concentrations ranged from 10.3 to 16.4 mm. Methanol extracts demonstrated varying degrees of effectiveness, with inhibition zones for 50 ml concentrations varying from 8.61.28 to 16.52.56 mm, and for 75 mL concentrations from 12.32.45 to 24.32.63 mm for 50 mg and 75 mg, respectively. Both extracts exhibited dose-dependent antibacterial activity, with higher concentrations generally resulting in larger inhibition zones. The results suggest that both aqueous extracts have the potential to inhibit fungal growth, with both extracts showing greater potency at lower concentrations.
A Critical Review of the Concept of Bāl Graha in Ayurveda with Correlation on Modern Pediatric Disorders
Kaumarbhritya is one of the branches of the “Ashtanga Ayurveda”. Balgraha is an abstract that is a part of Kaumarbhritya. The concept is quite distinctive which portrays the disease caused by the invisible vectors. This idea of Balgraha is not very acceptable nowadays due to Modernization of this era. For that reason, an attempt has been made to relate it to the modern era on the basis of the science and clinical application that can be practically applied on the patients. This review critically examines the classical Ayurvedic understanding of Bāl Graha with a comparative analysis to modern pediatric disorders such as epilepsy, autism spectrum disorder (ASD), ADHD, night terrors, and psychosomatic disorders. By integrating Ayurvedic principles with contemporary scientific insights, this paper aims to contextualize the relevance of Bāl Graha in modern child healthcare, explore potential correlations, and evaluate the therapeutic significance of Ayurvedic management strategies. The study also highlights the scope of interdisciplinary research to bridge traditional pediatric wisdom with modern neurodevelopmental science.
Impact of Tobacco Consumption on Cardiovascular and Respiratory Systems.
Tobacco consumption significantly harms both the cardiovascular and respiratory systems. It contributes to heart disease, high blood pressure, and stroke by damaging blood vessels and promoting atherosclerosis. In the lungs, tobacco smoke causes chronic inflammation, reduces lung function, and increases the risk of diseases like COPD and lung cancer. Reducing tobacco use through public health efforts is essential to prevent these life-threatening conditions. Objective: Impact of Tobacco Consumption on Cardiovascular and Respiratory Systems Methods: A cross-sectional study was conducted among voluntary male participants from Sarojini Naidu Medical College, Agra. The study included smokers aged 18–32 years with a minimum smoking history of one year. Results: The study demonstrated significant cardiovascular and respiratory impairments associated with tobacco consumption. Among smokers, systolic and diastolic blood pressures were elevated compared to non-smokers, indicating increased cardiovascular strain. Pulmonary function tests revealed reduced lung capacity and airflow obstruction in smokers, with a marked decline in forced expiratory volume (FEV1) and forced vital capacity (FVC) compared to controls. Conclusion: Tobacco consumption has a significant negative impact on both the cardiovascular and respiratory systems. It contributes to elevated blood pressure, increased cardiac workload, and impaired lung function, leading to a higher risk of heart disease, stroke, COPD, and lung cancer. Preventive measures and smoking cessation are essential to reduce these health risks and improve overall well-being.
Comparative Evaluation Of Conventional Clinical Methods And Artificial Intelligence-Based Diagnostic Models In The Detection Of Chronic Generalized Gingivitis
Gingivitis is one of the most prevalent periodontal diseases worldwide, and early, accurate diagnosis is critical for preventing progression to irreversible periodontitis. While conventional diagnostic indices such as the Gingival Index (GI) and Plaque Index (PI) are widely used, they are inherently subjective and examiner-dependent. Recent advances in artificial intelligence (AI) offer promising alternatives for objective, scalable, and efficient periodontal diagnostics. Aim: To compare the diagnostic accuracy, sensitivity, and consistency of conventional clinical methods with an Artificial Neural Network (ANN)-based AI model in evaluating gingival health across a large population. Materials and Methods: An in vivo comparative study was conducted on 1,000 patients aged 14 to 75 years at a tertiary dental care institution. Gingival condition was evaluated using the GI and PI, and scored for color, contour, interdental papilla form, and presence of calculus. Standardized intraoral images were captured and analyzed using a trained ANN model comprising four specialized sub-networks. Diagnostic scores from AI and clinical methods were statistically compared using t-tests, ANOVA, correlation matrices, and reliability testing. Results: Conventional methods diagnosed gingivitis in 100% of patients with perfect inter-parameter consistency (Cronbach’s α = 1.0). The ANN model demonstrated high sensitivity (99.8%) and good internal reliability (Cronbach’s α = 0.784), particularly in detecting interdental papilla (accuracy: 74.91%) and calculus (accuracy: 80.47%). However, the AI system underperformed in identifying gingival color changes (accuracy: 70.78%; consistency: 63.42%) and showed weaker correlation in its provisional classification (r = 0.044). Significant statistical differences (p < 0.001) were observed across all diagnostic categories between AI and conventional methods. Conclusion: AI-assisted gingivitis detection demonstrates high sensitivity and consistency, especially for morphological parameters, and holds strong potential as an adjunctive tool in periodontal diagnosis. However, limitations in detecting early color changes and calculus suggest the need for algorithmic refinement and dataset expansion. AI models, when optimized and integrated with clinical workflows, may serve as scalable, objective complements to traditional diagnostic methods in both routine and community-based periodontal care.
Neuropsychological And Behavioral Correlates Of Excessive Internet Use In Early Adolescents In Rajasthan
Internet addiction in adolescents has become a serious issue, especially in states that have recorded high levels of digital growth like Rajasthan. Patterns of usage increasingly lean toward recreational and social platforms, raising concerns about potential impacts on mental health, cognitive functioning, and academic performance. This study combines behavioral measures with district level contextual measures to offer a more complete picture of adolescent internet use as well as its related consequences. Quantitative values of the level of internet addiction, the motive of its use, and the psychological and cognitive tests were examined and compared with official data of the educational facilities, access to ICT, and socio-economic factors. The findings indicate a high rate of non-academic internet usage with an increase in the scores of addictions being associated with a high depression, anxiety, and stress levels, low attention span and academic performance. Results of contextual analysis indicate that there are considerable differences in ICT facilities, ownership of devices and access to educational resources in urban and rural areas, implying that both access and use patterns are dependent on infrastructural and socio-economic aspects. These results indicate that specific measures are needed to promote both digital access and responsible use, with school-based programs and policy efforts being used to minimize possible harms and maximize the positive potential of internet connectivity on adolescent development.
Three-Dimensional Morphometric Analysis of Human Cranial Sutures: Insights into Age-Related Variations
The age-related modifications of the cranial suture morphology are of equal importance to clinical psychiatry and rehabilitation as they are of forensic interest. The pattern of suture closure has been shown to alter cranial development and is also suspected to play a role in craniofacial dysmorphias and possible cognitive deficiency. Advanced morphometric definition of such transformations promises to provide valuable information to support the rehabilitation of psychiatry, because the correlation of the structure of the head with functional aspects of ageing and neurocognitive status is important. The analysis utilised the three-dimensional surface scanning and geometric morphometric methods to examine the cranial suture geometry at a large age interval. Geometric morphometrics using the landmarks, Procrustes superimposition and principal component analysis (PCA), were used to measure suture morphology. Multiple regressions were used to investigate the inter-relationship between chronological age, suture patterns and neurodevelopmental integrity implications. The results indicated a close age-related variation with intertwined sutures of complex morphology in younger specimens, which become simplified and partially obliterated in older skulls. CA explained 81% of the morphological differences and distinguished between younger and older ones. Analysis of regression indicated a strong correlation between suture simplification and age, which may have implications on the study of craniofacial contributions to cognitive aeing, thus offering a new avenue of inquiry in relation to psychiatric rehabilitation. The implications of these findings are the transferability of structural markers to the integrative interdisciplinary development of rehabilitation interventions.
Compare the safety and efficacy of Propranolol versus Nortriptyline as Monotherapy for Migraine Prophylaxis.
Objective: To compare the safety and efficacy of Propranolol and Nortriptyline as monotherapy in the prophylactic treatment of migraine. Methods: This study evaluated patients diagnosed with migraine who were treated with either Propranolol or Nortriptyline. The primary endpoints included reduction in frequency, severity, and duration of migraine attacks. Secondary outcomes assessed the tolerability and side effect profile of each medication. Results: Nortriptyline demonstrated superior efficacy compared to Propranolol, significantly reducing the frequency, intensity, and duration of migraine episodes. However, Propranolol was better tolerated, with fewer and less severe side effects reported. Conclusion: In This study indicates that Nortriptyline is more effective than Propranolol in migraine prevention, particularly in reducing the frequency, severity, and duration of attacks. However, Propranolol demonstrates better tolerability with fewer side effects. While Nortriptyline appears to be the more efficacious option for migraine prophylaxis, Propranolol may be preferred in patients who prioritize minimal adverse effects.
Quality of Life in Caregivers of Patients with Mental Retardation: A Cross-Sectional Study
Mental retardation (MR) is a lifelong condition that significantly impacts not only patients but also their caregivers. The quality of life (QOL) of caregivers can be adversely affected due to continuous caregiving , stress, and socio-economic challenges. This study aimed to assess the QOL of caregivers of patients with MR responsibilities and analyze its relationship with socio-demographic variables of both patients and caregivers, as well as clinical variables related to the severity of MR. AIMS AND OBJECTIVES:- The study aims to assess the quality of life of caregivers of patients with mental retardation in relation to socio-demographic factors and severity of illness. Material and Methods: A cross-sectional study was conducted involving 100 patients diagnosed with mental retardation and their respective caregivers. Caregivers’ QOL was measured using a standardized QOL questionnaire, and socio-demographic and clinical data of both patients and caregivers were collected. Statistical analyses were performed to determine the correlation between QOL scores and various socio-demographic and clinical factors, with significance tested at p<0.05. Results: Caregivers’ QOL scores ranged from 29% to 86%, with a mean score of 52.6% (SD=10.4), indicating a moderate impairment in quality of life. Patients’ age showed an inverse relationship with caregivers’ QOL; however, other patient variables such as sex, domicile, religion, education, and occupation showed no significant correlation with caregiver QOL. Caregivers’ age was also negatively correlated with their QOL, while their education, marital status, type of family, and per capita income showed significant positive associations with better QOL scores. Caregivers’ sex, domicile, religion, occupation, and relationship to the patient were not significantly related to their QOL. Severity of MR did not significantly influence caregivers’ QOL; however, caregivers of patients with MR and comorbid epilepsy reported significantly poorer QOL scores compared to those without epilepsy. Conclusion: The study reveals that caregivers of individuals with mental retardation experience moderately impaired quality of life, influenced more by socio-demographic factors than by the severity of the patient’s condition. Caregiver support programs and policies need to focus on improving socio-economic conditions and providing psycho-social assistance to enhance caregiver well-being.
The Chinese version of the Citizenship Measures: Internal consistency and test-retest reliability among Chinese adults in mental recovery
Citizenship is a person's connection to the 5 R's of rights, responsibilities, roles, resources, and relationships. This study aimed to develop the Citizenship Measures (CM) (Chinese) and test its internal consistency and test-retest reliability followed by assessing the degree to which individuals in recovery in Hong Kong engaged with social citizenship. The original English version was translated into Chinese, and then back-translated, followed by a cognitive interview. Individuals aged ≥18 years who were receiving community mental health services completed the CM (Chinese). An overall Cronbach’s alpha of 0.96 was found, indicating excellent internal consistency. The intraclass correlation coefficient was 0.83, indicating good test-retest reliability. The CM (Chinese) is a reliable tool for assessing the degree to which individuals in recovery in Hong Kong perceive themselves to be citizens and measuring changes in the seven clusters associated with citizenship between two assessment time-points.
Need For Interprofessional Collaboration For Depression Interventions: From Research To Future Directions
Severe mental health conditions (SMHC) can result in detrimental health complications and affect the quality of life of people with these diagnoses. These conditions are associated with a decreased life span related to comorbidities, which largely impact the global health burden and healthcare costs. Therefore, exploring approaches other than standard treatment protocols to manage SMHCs is crucial. Interventions related to diet and nutrition have a positive association with improvement in mental health conditions, including depression. Access to interprofessional care, including mental health counseling and diet interventions, may benefit the treatment and management of SMHC.
Health Disparities and Socioeconomic Inequalities: Investigating the Link between Poverty and Public Health Outcomes
The presence of socioeconomic inequalities, especially the issue of poverty, is one of the primary factors that influence the results of the population health in a complicated interaction of the social determinants and access to healthcare. The given work analyzed the relationship between poverty and health inequality in terms of the prevalence of chronic diseases, mental health issues, and the expected lifespan of low, middle, and high-income groups. The research was set as mixed-methods research that had a quantitative analysis (using national data sets where income, education and employment status were linked with health outcomes) and a qualitative analysis (using interviews and focus groups to represent the lived experiences of barriers to healthcare access). Quantitative data showed a sharp social gradient: the prevalence of chronic diseases was 45 and 15 percent in low-income and high-income populations, respectively, and the difference in life expectancy was 7-10 years. There was also an increased risk of anxiety, depression, obesity, hypertension, and diabetes with lower income. Cost, provider shortage, and low health literacy were cited as major obstacles to qualitative evidence, in addition to psychosocial stress and social isolation. Triangulation ensured that there were similarities in the data sources. The findings underlined the importance of structural policy modification that ought to focus on healthcare access, housing, education, and community-based measures to minimize health disparities and enhance outcomes of the underprivileged groups.
The Psychotherapy For NPD Through The Wisdom Of The Śrīmad Bhagavadgītā
Narcissistic personality disorder (NPD) is a mental condition where a person thinks they are very special and important, always wants others to admire them, does not care about other people’s feelings and emotions and emotionally hurt them for own satisfaction. People who have this disorder feel deeply insecure, so they depend on other’s praise and glorification to feel good about themselves. While modern psychotherapy offers valuable treatments for NPD, the Śrīmad Bhagavadgītā, an ancient sanskrit spiritual scripture which is regarded as the world’s first psychological text, also provides a deeply spiritual path to healing. Lord Kṛṣṇa’s teachings and advice always guide people toward knowing their true self and becoming humble. Such advice also help to develop empathy for others and free the mind from the grip of the ego. This eternal wisdom directly addresses and counters the ego, which is the main cause of NPD, offering not just treatment but true inner transformation. The Bhagavadgītā teaches Jñāna Yoga (self), Karma Yoga (selfless action), Bhakti Yoga (devotion), and not being attached to results. These teachings help people overcome ego, rudeness, lack of empathy, and self-centeredness, which are commonly seen in narcissism.
Retrospective Study of Paraquat Poisoning in the Khandesh Region: Clinical Outcomes and Mortality Predictors
Introduction: Paraquat is a widely used non-selective herbicide in India, especially in rural agricultural regions, and is associated with high morbidity and mortality due to the absence of a specific antidote and rapid progression to multi-organ failure [1]. In North Maharashtra, agricultural dependency, easy availability of paraquat, and limited awareness of its toxicity contribute to frequent accidental or intentional exposures. This study was conducted to evaluate the demographic, clinical, laboratory, and treatment profiles of paraquat poisoning patients, along with their outcomes, to generate evidence for improving prevention and management strategies. Methodology: A hospital-based observational study was conducted at a tertiary care center in North Maharashtra, including 34 confirmed cases of paraquat poisoning admitted during the study period. Data were collected from patient medical records and included demographic details, presenting clinical signs, postmortem findings where applicable, laboratory investigations, treatment modalities, and outcomes. Statistical analysis was performed to determine the frequency and percentage distribution of variables. Results: The majority of patients were males (64.7%) and farmers (61.8%), with the highest incidence in the 21–30 years (23.5%) and 31–40 years (20.6%) age groups. Oral ulcers/mucosal burns were observed in 41.7% of cases, lung congestion in 58.3%, and kidney congestion in 52.8%. Laboratory abnormalities included elevated AST/ALT in 38.2%, hyperbilirubinemia (>2 mg/dL) in 41.2%, elevated creatinine in 52.9%, and low hemoglobin in 44.1%. Steroids were administered to 58.8% of patients, cyclophosphamide to 17.6%, and dialysis to 8.8%, while hemoperfusion was rarely used (2.9%). The overall in-hospital mortality was 61.8%, with multiorgan failure (71.4% of deaths) as the leading cause, followed by acute kidney injury (23.8%) and acute lung injury (4.8%). Conclusion: Paraquat poisoning in North Maharashtra predominantly affects young male farmers and carries a high mortality rate despite medical intervention. The study highlights the need for stricter regulation of paraquat sales, farmer education on its hazards, and improved access to advanced therapeutic measures such as hemoperfusion to reduce mortality.
"A Cross-Sectional Study on the Impact of COVID-19 on Mental Health Among Health Care Workers"
The COVID-19 pandemic has significantly impacted the mental health of healthcare workers (HCWs) globally, leading to increased rates of stress, anxiety, and depression. Understanding these impacts is crucial for developing targeted interventions and support systems. Objective To assess the prevalence of mental health issues among healthcare workers during the COVID-19 pandemic and identify associated risk factors using validated psychological assessment tools. Methods A cross-sectional study was conducted among 200 healthcare workers from a tertiary care hospital. Mental health assessment was performed using the Depression, Anxiety and Stress Scale-21 (DASS-21) and Perceived Stress Scale (PSS). Demographic and COVID-19 exposure data were collected through structured questionnaires. Results The study revealed significant mental health challenges with stress being the most prevalent condition (59% by DASS-21, 57% by PSS), followed by anxiety (54%) and depression (35%). Female healthcare workers demonstrated higher mental health risks across all parameters. Nurses exhibited elevated risk levels compared to doctors and medical administrators. Age groups 20-25 years and 46+ years showed higher vulnerability. COVID-19 exposure history significantly impacted mental health outcomes. Conclusion Healthcare workers experienced substantial mental health burden during the COVID-19 pandemic, with specific demographic and professional groups at higher risk. These findings emphasize the urgent need for targeted psychological interventions and support systems for healthcare personnel.
Omni-Channel Approach For Mentoring Community Health Officers To Improve Quality Of Health Services In Ayushman Arogya Mandirs Of Bihar
The Ayushman Bharat initiative in India, which envisions the transformation of sub-health centres into Ayushman Arogya Mandirs (AAMs), represents a milestone in India's journey towards Universal Health Coverage (UHC). AAMs are mandated to deliver comprehensive primary healthcare through the deployment of Community Health Officers (CHOs) as mid-level service providers. Despite their crucial role, CHOs face challenges including clinical uncertainty, administrative bottlenecks, and suboptimal community engagement. This study evaluates the effectiveness of an Omni-Channel Mentorship Approach (OCA) in enhancing the performance of CHOs in Madhubani district, Bihar. The mentorship combined virtual and onsite engagements, targeting clinical capacity, administrative efficiency, and community participation. Using a mixed-method design, data from 30 AAMs were analysed before and after the intervention. Findings revealed statistically significant improvements in outpatient attendance (P<0.01), non-communicable disease screening (P<0.01), antenatal care check-ups (P<0.05), VHSND conducted (P<0.05); health education sessions (P<0.01) and essential drug availability (P<0.01). Qualitative findings highlighted increased CHO confidence, operational efficiency, team coordination and stronger community interface. Authors argue that structured and context-specific mentoring mechanisms are critical for optimizing the AAM model, especially in underserved regions. Institutionalizing mentorship protocols, developing standardized monitoring tools, and policy-level integration are essential for sustainable CHO capacity building for optimizing primary healthcare delivery in resource-constrained settings.
OBSERVATION OF DIABETES AMONG COVID-19 PATIENTS HAVING LOW CT VALUE IN RT-PCR
To observe diabetes among COVID-19 patients having low Ct-value in RT-PCR. Methods: An observational study was done using RT-PCR on oropharyngeal and nasopharyngeal samples in April 2021. Results: A total of 15,831 samples were received in April 2021 out of which 11,210 (71%) were COVID-19 positive and 4,621 (29%) were negative. 55±10 years was the mean age of patients. The age of two-third of patients was 26-50 years, one-third were below 25years. More than three-quarter (68%) of patients were males and rest (32%) were females. Among 11,210 positive patients 998 (9%) were diabetics and 102 (0.9%) patients among diabetics were non diabetic before COVID-19 infection. In diabetic patients mild 130 (13%), moderate 299 (30%) and severe 569 (57%) COVID-19 disease was seen. Conclusion: The study population either had a previous history of diabetes or developed high blood sugar levels following COVID-19 infection. In our study we report that COVID-19 patients having low Ct value in RT-PCR had high prevalence (57%) of DM.
Effect Of Continuous Positive Airway Pressure Therapy On Glycemic Control And Blood Pressure In Patients Having Obstructive Sleep Apnea
Introduction: OSA is a sleep disorder which causes repetitive episodes of complete or partial obstruction of upper airway during sleep which lead to Sleep fragmentation. Alterations in human body caused by untreated OSA likely contribute to development of insulin resistance and type 2 diabetes. Common treatment for obstructive sleep apnea is CPAP. CPAP eliminate OSA that help to breathe during sleep and prevent sleep fragmentation, and activation of the sympathetic nervous system. So, this study was conducted to find whether CPAP therapy in patients having OSA really improve glucose metabolism or not. Materials and Method: First of all, written consent was taken then Polysomnography for all these subjects were done from 10 pm to 6 am at Sleep Research Centre, MGM Hospital, Kamothe Navi Mumbai. Apnea hypopnea index was obtained from polysomnogram. Subjects having AHI ≥ 5 were included in the study. After polysomnography recording is over, at around 6:30 am, fasting blood sample was collected for fasting blood glucose level and HbA1c investigation of these subjects. Then, for 2 months, subjects were made to use CPAP for 6 hours every night while sleeping. After Two months of CPAP use polysomnography recording and blood investigation of these subjects were done again. Then comparison between all parameters of subjects before CPAP use and after CPAP use were done. Results: CPAP use increases sleep efficiency%, mean TBI SPo2%, SBP, DBP significantly. It decreases Apnea-Hypopnea Index (AHI) significantly. It also insignificantly decreases FBS, HbA1c%. Conclusions: CPAP treatment reduces obstructive sleep apnea (OSA), increases oxygen saturation and sleep efficiency and improve glycemic control.
The Effect of Storage Duration and Temperature on the Biochemical and Physiological Quality of Red Blood Cells
Background: Red blood cell (RBC) storage induces biochemical and biophysical changes that impair cell quality and transfusion efficacy. Understanding these storage lesions is critical to optimize blood banking practices. Objective: This study investigates the effects of storage duration and temperature on RBC membrane integrity, deformability, metabolic status, and hemolysis. Methods: RBC units were stored under controlled temperature conditions, and samples were analyzed periodically for membrane composition, microvesiculation, rheological properties, morphology, metabolic markers, and hemolysis rates. Results: Prolonged storage resulted in significant membrane alterations, increased microvesiculation, reduced deformability, metabolic decline, and elevated hemolysis, particularly at suboptimal temperatures. Conclusions: Storage duration and temperature critically affect RBC quality, emphasizing the need for improved storage protocols to enhance transfusion outcomes.
Outcomes and Risk Factors in Acute Renal Failure: A Cross-Sectional Study of Hospital and Community-Acquired Cases
Introduction Acute kidney injury (AKI) is a common and severe condition associated with high morbidity and mortality. The aim of this study was to compare the incidence, etiological factors and clinical outcomes between community-acquired (CA-ARF) and hospital-acquired (HA-ARF) acute renal failure in a tertiary care setting. These results will aid in identifying factors that may be targeted for improved clinical intervention and comprehensive patient management. Methodology A cross-sectional observational study done in a government medical college of North Maharashtra in 162 hospitalized patients diagnosed as having AKI. The patients were classified into two groups consequently as CA-ARF and HA-ARF depending on the emergence status of AKI. This included data collected retrospectively from patient charts, including demographic details, comorbidities, AKI stage, laboratory results and clinical outcomes. Univariate, multivariate logistic regression analysis was used for identifying the independent predictors of poor outcomes like mortality and dialysis requirement. Results The majority (67.3%) of the study participants had Stage 1 AKI, while fewer were found to have Stage 2 (22.2%) and Stage 3 AKI (10.5%). Community-acquired AKI occurred in most patients (71.6%), while 28.4% with hospital-acquired AKI Independent predictors of poor outcomes were advanced age, diabetes, episodes in the AKI stage and nephrotoxic drug use. Results: Overall 28-day mortality was 94% in patients developing Stage-3 AKI and diabetes was associated with higher odds of Bad outcome (OR=2.15). Creatinine levels at admission and hospital-acquired AKI were significant risk factors in the logistic regression. Conclusion This study underscores the importance of AKI stage, diabetes, age, and nephrotoxic drug use as key predictors of poor outcomes in AKI patients. The findings emphasize the need for early diagnosis and timely management, particularly in high-risk populations. Effective monitoring and interventions, especially in patients with comorbidities such as diabetes, can significantly improve survival rates and reduce the need for renal replacement therapy.
Pharmacological Synergy: Systematic Review Of Glp-1 And Gip Receptor Co-Activation By Tirzepatide
Tirzepatide represents a breakthrough in metabolic therapeutics as a dual agonist of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors1. This systematic review synthesizes evidence on its pharmacological mechanisms, clinical efficacy, safety profile, and broader implications for type 2 diabetes and obesity management. Drawing from major clinical trials and mechanistic studies, Tirzepatide demonstrates superior glycemic control (mean HbA1c reduction of 1.8-2.6%) and weight loss (up to 25% body weight reduction) compared to single GLP-1 agonists2,3, attributed to synergistic receptor co-activation. Safety data indicate transient gastrointestinal effects as primary concerns, with low hypoglycemia risk4. Future research should explore long-term outcomes and pharmacogenomic influences to optimize personalized therapy.
Beam Data Validation for Treatment Planning System Considering AAPM TG 119 Protocol as A Verification Tools for Low, Medium and High Energy Beam While Shifting from Flatten Beam to Unflatten Beam.
Purpose: Our research aimed to find out how the commissioning parameter of TG119 will change when we shift from a low-energy (6MV) to medium energy (10MV) to high energy (15MV) for RapidArc (RA) and Intensity-modulated Radiotherapy (IMRT) plans. Methods: We evaluate effect of dose rate, gantry speed, leaf speed, and intentional error by Picket Fence(PF) tests using Electronic Portal Imaging Device(EPID) and EBT 3 films. For comparison, RA and IMRT plans are made for all tests as per American Association of Physicists in Medicine Task Group-119 (AAPM TG-119). Confidence Limit (CL) was set to have 95 percent of the measured data within tolerance limit. Results: Average absolute deviation (DiffAbs) for variable Dose Rate & Gantry Speed (DR_GS) has been within 1.5 %. For 6MV, 10MV, and 15MV energies. Their (DiffAbs) for variable leaf speed and dose rate (LS_DR) was also within 1.5%. TG 119 recommendations and methodology were evaluated effectively to check commissioning precision of flatten and unflatten beams for IMRT and RA modality to set reference values. Conclusion: Understanding a system's limitations is better before using it in a clinical application. To guarantee accurate delivery of RapidArc and IMRT plans for 6MV, 10MV and 15MV beam modalities, measurements and accepted CL values can be utilized as baseline to evaluate quality of QA procedure.
Seasonal Regimen In Ayurveda (Ritucharya): An Ancient Lifestyle Science With Modern Applications
Ritucharya provides a systematic framework for adapting to environmental shifts to prevent illness, boost immunity, and promote overall vitality. Drawing extensively from classical Ayurvedic texts, particularly the Charaka Samhita, this paper details specific seasonal recommendations across the six Ritus (seasons). Furthermore, it bridges this ancient wisdom with modern scientific understanding, discussing how contemporary research in chronobiology, metabolism, immune function, and the gut microbiome validates many of Ayurveda's core tenets. The report highlights Ritucharya's potential as a proactive, personalized approach to health maintenance, offering valuable strategies for addressing the rising prevalence of lifestyle disorders in the modern era and identifying key areas for future empirical research. A cornerstone of Ayurvedic philosophy is its strong emphasis on preventive medicine, encapsulated in the dictum "Swasthyashya Swasthya Rakshanam" (to maintain the health of the healthy). This proactive stance aims to prevent the onset of disease rather than solely focusing on its cure, highlighting a foresight into health management that remains highly relevant today. Ritucharya can be understood as a comprehensive manual for adjusting daily routines to the environment, ensuring the body's internal equilibrium is maintained. This systematic framework for human physiological and behavioral adaptation to environmental shifts demonstrates a profound, ancient understanding of human ecology, where health is viewed as a dynamic balance with the external world. It provides a proactive blueprint for resilience against environmental stressors, a concept increasingly vital in modern environmental health discussions.[i] The principles of Ritucharya are deeply embedded in classical Ayurvedic literature, being prominently discussed in the foundational Ayurvedic Samhitas. The Charaka Samhita, considered one of the foremost texts of Ayurveda, dedicates its sixth chapter of Sutra Sthana, known as "Tasyashiteeya Adhyaya", to elaborating on the detailed seasonal regimens.
Panchamahabhuta Siddhanta: Philosophical Foundation And Scientific Interpretation – A Review
Panchamahabhuta Siddhanta, a fundamental philosophical concept in Ayurveda. It delves into the etymological and philosophical origins of the five great elements Akasha (Ether/Space), Vayu (Air), Agni (Fire), Jala (Water), and Prithvi (Earth)—tracing their evolution from ancient Indian philosophical schools, particularly Sankhya and Nyaya-Vaisheshika. The paper elucidates their intricate roles in Ayurvedic physiology, including their influence on the Tridoshas, Sapta Dhatus, embryonic development, and pharmacological principles. Furthermore, it critically examines potential correlations between Panchamahabhuta principles and modern scientific disciplines such as biochemistry, anatomy, and pharmacotherapeutics, highlighting areas of convergence and divergence. The clinical significance of this Siddhanta in Ayurvedic diagnosis and individualized therapeutic interventions is discussed, alongside the challenges and opportunities for integrating traditional wisdom with contemporary scientific paradigms. This review aims to bridge the understanding between classical Ayurvedic texts and modern scientific inquiry, fostering a holistic approach to health and disease.
The Concept Of Sadvritta (Right Conduct) In Ayurveda: A Review Of Its Psychosocial Impact On Mental And Spiritual Wellbeing
Ayurveda, an ancient Indian system of medicine, offers a profound and holistic understanding of health that extends beyond the mere absence of disease to encompass physical, mental, social, and spiritual well-being. Central to this comprehensive health paradigm is Sadvritta, a code of ethical and moral conduct. This review explores the multifaceted concept of Sadvritta as delineated in classical Ayurvedic texts, examining its five classifications: Vyavaharika (ethical), Samajika (social), Manasika (mental), Dharmika (moral), and Sharirika (physical) Sadvritta. The article critically reviews the psychosocial impact of these principles on mental well-being, drawing explicit parallels with contemporary psychological concepts such as prosocial behavior, self-control, gratitude, and compassion, supported by modern empirical research. Furthermore, it delves into Sadvritta's intricate contribution to spiritual well-being, emphasizing its role in cultivating inner strength, purpose, and clarity through the modulation of Gunas. By bridging ancient Ayurvedic wisdom with modern scientific understanding, this review highlights the enduring contemporary relevance of Sadvritta as a preventive and therapeutic framework for addressing prevalent lifestyle disorders and mental health challenges, advocating for its integration into modern health and wellness paradigms.[i]
The Relationship Between Self-Regulation and Psychological Well-Being Among School Teachers
This study aimed to examine the relationship between self-regulation and psychological well-being among secondary school teachers in the Seberang Perai Selatan district of Penang, Malaysia. The research was motivated by growing concerns over the declining psychological well-being of teachers due to excessive workload, administrative pressure, and emotional exhaustion, which have implications for education quality and early retirement rates. A total of 54 teachers were selected as respondents using a systematic sampling method. The instruments used in this study were the Teacher Self-Regulation Scale (TSRS) and Ryff’s Psychological Well-Being Scale (PWB). Findings revealed that teachers generally demonstrated a good level of self-regulation, while most reported a moderate level of psychological well-being. Pearson correlation analysis showed a significant positive relationship between self-regulation and psychological well-being (r = .566, p < .001). These results support previous findings that highlight the importance of self-regulation in promoting emotional and professional well-being among teachers. The study recommends the implementation of structured interventions focused on self-regulation development and psychosocial support within teacher professional training to ensure mental well-being and the sustainability of the teaching profession.
"Postpartum Mental Health In A Low-Resource Setting: Prevalence, Risk Factors, And Symptom Patterns Among Sudanese Women"
Background: Despite the presence of psychological disorders like depression, anxiety and post-traumatic stress disorder (PTSD), maternal health and infant growth are significantly threatened in low-resource settings. This study aims to investigate the frequency, factors and indications of psychological problems experienced by women from Sudan. Methodology: We conducted a descriptive cross-sectional study between January 2022 and December 2022, involving 602 postpartum women, assessing their psychological status at three intervals: days 3–7, week 6, and week 12. Standardised psychometric instruments (EPDS, GAD-7, PCL-5) and the application of multivariate logistic regression along with latent class growth analysis (LCGA) were used to identify risk factors and symptom patterns. Results: In total, 37.4% of the cases were associated with psychological disorders. At week 6, depression reached its peak at 28.2%, while PTSD rose steadily to 16.7% by week 12. Among the predictors of depression and PTSD, emergency cesarean birth was significantly associated with increased psychological morbidity (OR = 2.14; 95% CI: 1.52–3.01), although the odds ratio did not exceed the higher clinical relevance threshold of 2.68 observed for PTSD. Greater psychological harm was correlated with reduced earnings, unreliable marriages, and low education levels. Three distinct pathways were identified by LCGA: Resilient (48.2%), Emerging Distress (32.5%), and Chronic Distress (19.3%), the latter of which showed extended symptom load and a concentration of inpatient NICU exposure. Conclusion: Sudanese women frequently experience psychological disorders after childbirth, characterized by distinct risk factors and changing patterns. Significant indicators include emergency cesarean section, social issues, and inadequate support networks. To aid women in their recovery, routine mental health assessments and targeted therapies are necessary.
Comparative Diagnostic Yield of 3 Tesla Versus 1.5 Tesla MRI in Early Detection of Multiple Sclerosis Among Saudi Patients: A Prospective, Blinded Study
Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and neurodegeneration. Early and accurate diagnosis is critical to initiate disease-modifying therapies and improve patient outcomes. High-resolution magnetic resonance imaging (MRI) at 3 Tesla (3T) has been shown to offer superior sensitivity in detecting MS lesions compared to conventional 1.5 Tesla (1.5T) MRI; however, comparative data specific to the Saudi population remain limited. Aim: This study aims to evaluate the effectiveness of high-resolution 3T MRI compared to conventional 1.5T MRI in the early detection of multiple sclerosis lesions among Saudi patients. Methods: A prospective comparative study was conducted involving Saudi patients presenting with clinical features suggestive of early MS. Each participant underwent both 1.5T and 3T brain and spinal MRI scans following the same imaging protocols based on the 2017 McDonald Criteria. Lesion load, anatomical distribution, and contrast enhancement characteristics were independently assessed by two blinded neuroradiologists. Statistical analysis was performed to compare the diagnostic yield of 3T versus 1.5T MRI. Results: A total of 60 patients were enrolled (mean age 29.4 years; 63.3% female). The average lesion count per patient was significantly higher on 3T MRI (mean = 9.2, SD = 3.4) compared to 1.5T MRI (mean = 6.1, SD = 2.9; p < 0.001). Lesions were more frequently detected across all anatomical regions with 3T imaging, including the periventricular (p = 0.003), juxtacortical (p = 0.001), infratentorial (p = 0.007), spinal cord (p = 0.009), and corpus callosum (p = 0.012) areas. Contrast-enhancing lesions were identified in 30.0% of patients using 3T MRI versus 16.7% with 1.5T (p = 0.039). Inter-observer agreement was higher for 3T (κ = 0.89) than 1.5T (κ = 0.76), indicating improved diagnostic consistency. Conclusion: Preliminary findings suggest that 3T MRI may provide enhanced sensitivity in the early identification of MS lesions compared to 1.5T MRI in Saudi patients. Improved lesion detection at higher field strength could contribute to earlier diagnosis, better disease monitoring, and potentially optimized therapeutic interventions. Further analysis of the full study data will confirm these observations and inform future imaging protocols for MS evaluation in Saudi Arabia.
Efficacy, Effectiveness, and Safety of Psilocybin and Ketamine versus Conventional Treatments or Placebo in Adults with Treatment-Resistant Depression: A Systematic Review
Background: Treatment-resistant depression (TRD) is a severe form of major depressive disorder that does not respond to at least two adequate antidepressant trials. Emerging evidence suggests that psilocybin and ketamine may produce rapid, clinically meaningful antidepressant effects, but no prior systematic review has directly compared their efficacy, effectiveness, and safety in TRD. Objective: To systematically assess the efficacy, real-world effectiveness, and safety of psilocybin and ketamine/esketamine compared with conventional pharmacologic treatments or placebo in adults with TRD. Methods: Following PRISMA guidelines, we included randomized controlled trials (RCTs), open-label, and prospective observational studies in adults with TRD. Primary outcomes were changes in depressive symptoms (e.g., MADRS, QIDS-SR16), response/remission rates, and safety. Due to clinical heterogeneity, no meta-analysis was performed. Results: Nine studies met inclusion criteria. Psilocybin (25 mg COMP360) reduced MADRS scores by 12.0 points at 3 weeks versus 5.4 with placebo (adjusted difference: −6.6; p < 0.001). In another RCT, remission rates were higher with psilocybin (57%) versus escitalopram (28%). Intravenous ketamine (0.5 mg/kg) produced ~8-point MADRS reductions at 24h, with 64% achieving response versus 28% with placebo. Intranasal esketamine showed 4–6 point greater MADRS reductions over 4 weeks compared to placebo. Adverse effects for both agents, including dissociation, nausea, and mild hypertension, were transient and manageable. Conclusions: Both psilocybin and ketamine demonstrate rapid antidepressant effects with acceptable safety in TRD. Psilocybin may achieve sustained remission with minimal dosing, while ketamine/esketamine require ongoing administration. Further long-term, head-to-head trials are warranted to establish comparative effectiveness and durability of response.
Effectiveness Of Training Programme Among Security Personnel Regarding Knowledge Of Violence Management In Hospital Setting”: A Narrative Review
Introduction: Hospitals have faced growing challenges in ensuring the safety and security of their premises, patients, staff, and visitors. Training programs for security personnel in hospital settings play a crucial role in addressing these challenges and enhancing overall safety and security measures Materials and methods: A systematic literature review was conducted using PubMed, Scopus, and Google Scholar, focusing on studies from France, Italy, Spain, the USA, Canada, and India. The inclusion criteria consisted of experimental and qualitative studies that assessed the impact of training programs on violence management in hospital settings. The selected studies involved pre-tests, post-tests, and demonstration sessions. Results: Workplace violence (WPV) against healthcare workers, especially nurses, is widespread globally (14–43% prevalence), with verbal abuse, humiliation, and physical aggression most common. Perpetrators are often patients, relatives, or colleagues, with psychiatric units, emergency departments, and surgical wards most affected. Younger and male staff face higher risks of injury and absenteeism. WPV causes significant physical, psychological, and occupational harm, yet remains underreported due to perceived inaction. Risk factors include shift work, department type, and poor preventive measures. Training boosts confidence but fails to sustain reduction without organizational strategies. Integrated prevention, strong reporting systems, hazard pay, and safety-focused culture are essential. Conclusion: It was found that training is effective in improving knowledge, skills and confidence of the participants.
Impact of Structured Primary Care Follow-Up on Maternal and Neonatal Outcomes Among Women with Gestational Diabetes Mellitus in Saudi Arabia: A Retrospective Cohort Study
Background: Gestational diabetes mellitus (GDM) is associated with increased maternal and neonatal morbidity. Postpartum follow-up is critical for glycemic control and prevention of complications, yet many women fail to receive structured care. Objective: To assess the impact of structured primary care follow-up on maternal and neonatal outcomes among Saudi women diagnosed with GDM. Methods: A retrospective cohort study was conducted at three primary healthcare centers and affiliated tertiary hospitals in Riyadh and Al-Baha. Women aged 18–45 with singleton pregnancies and GDM (diagnosed 2021–2024) were stratified into structured (≥4 visits) and unstructured (<2 visits) follow-up groups. Data were extracted from electronic records. Outcomes included preeclampsia, cesarean delivery, neonatal hypoglycemia, macrosomia, NICU admission, and HbA1c levels. Chi-square and t-tests assessed group differences. Logistic regression identified adjusted predictors (p < 0.05). Results: Among 300 women (150/group), the structured group had lower rates of preeclampsia (8.7% vs. 17.3%, p = 0.02), cesarean delivery (33.3% vs. 46.7%, p = 0.01), neonatal hypoglycemia (10.0% vs. 20.7%, p = 0.005), and macrosomia (6.0% vs. 13.3%, p = 0.01). NICU admission was also reduced (13.3% vs. 22.0%, p = 0.04). Third-trimester HbA1c was significantly lower in the structured group (5.9% vs. 6.3%, p = 0.01). Conclusion: Structured primary care follow-up is associated with improved maternal and neonatal outcomes among women with GDM. Integrating standardized follow-up pathways in primary care settings may enhance clinical outcomes and long-term glycemic control in this population.
The relationship of Social Exclusion and Problematic Internet Use: Mediating Role of Ego Depletion
Social exclusion represents a significant psychological stressor that may lead to maladaptive coping behaviors among university students. This study investigated the relationship between social exclusion and problematic Internet use, with ego depletion as a potential mediating mechanism. A cross-sectional survey design was employed to examine 479 university students aged 18-25 years. Participants completed validated measures of social exclusion, ego depletion, and problematic Internet use. Structural equation modeling was used to test the proposed mediation model. Results demonstrated a significant positive correlation between social exclusion and problematic Internet use (β = 0.467, p < 0.001). Ego depletion significantly mediated this relationship, with an indirect effect of 0.255 (95% CI [0.201, 0.312]), accounting for 54.6% of the total effect. The mediation model showed good fit indices (CFI = 0.952, RMSEA = 0.053). Findings indicate that social exclusion increases the risk of problematic Internet use through the depletion of self-regulatory resources. Although the cross-sectional design limits causal inference, results provide theoretical support for interventions targeting self-regulation capacity and social integration.
Psychological effects on Return to Sports after ACL Reconstruction
The knee joint is the largest and most complicated joint in the human body.1 Primary knee stabilization is achieved through knee ligaments, while muscles around the knee play a secondary role.2
A comparative Exploration of Psychosocial Profiles of eSports and sports players
Background: The commercial association has made computer-based games very attractive, providing a platform where they are being considered on similar lines as traditional/real sports. However, despite the similarities there exists considerable difference primarily because of the extent of physical involvement. The study intended to explore the psychosocial profile of Esports players and traditional sports players. Methods: The study sample consisted of 140 participants (73 esports & 67 sports). In this cross-sectional study, we recruited participants from Esports cafes, Youth Sports centers & Universities and collected their sociodemographic variables and psychosocial profile with Mini-International Personality Pool 6, Self-Concept Clarity Scale, UCLA Loneliness Scale Version 3, Satisfaction with Life Scale, and Depression, Anxiety and Stress Scale-21. Results: The mean age of Esports and sports players were 23.11± 4.60 years and 22.24± 3.22 years respectively. Both categories of players differed in terms of hours of play on weekdays/weekend, process of introduction to games, engagement of family and methods used to improve game play. For Psychological variables, esports players were likely to report significant higher scores on openness (β= -0.151, CI=.769-.962) and honesty/Humility (β= -0.151, CI=.672-.863) compared to sports players but not on other variables of depression, anxiety, stress, loneliness, self-concept, and satisfaction with life. Conclusions: Our study points out that despite differing in Socio-demographic and playing variables, esports and sports players tend to exhibit much similarity in psychological domains. Further longitudinal studies are warranted to extend the application and generalizability of our study results.
Evaluating the Impact of Patient-Centered Health Education Programs on Glycated Hemoglobin (HbA1c) Control Among Type 2 Diabetes Patients in Saudi Arabia: A Systematic Review
Background: Type 2 diabetes mellitus (T2DM) remains a major public health issue in Saudi Arabia, with poor glycemic control contributing to long-term complications. Patient-centered health education programs have emerged as promising tools to support self-management, yet their effectiveness in the Saudi context requires systematic evaluation. Objective: To assess the impact of patient-centered health education programs on glycated hemoglobin (HbA1c) levels among adults with T2DM in Saudi Arabia. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, Embase, Web of Science, and the Saudi Digital Library were searched for studies published between 2010 and 2025. Eligible studies involved adult Saudi patients with T2DM who participated in structured patient-centered education, reporting HbA1c outcomes. Results: Fifteen studies were included, comprising randomized controlled trials, cohort, and quasi-experimental designs. All studies reported reductions in HbA1c, ranging from 0.6% to 2.1%. Multidisciplinary education, culturally tailored programs, pharmacist-led medication therapy management, and telenursing follow-ups were particularly effective. Conclusion: Patient-centered education programs significantly improve HbA1c levels in Saudi patients with T2DM. National strategies should prioritize scaling such interventions through primary healthcare, supported by digital platforms and culturally relevant content.
The Impact of Long-Term Use of Proton Pump Inhibitors (PPIs) on Drug and Vitamin Absorption in Patients
Proton Pump Inhibitors (PPIs) are among the most commonly prescribed medications worldwide for conditions related to excessive gastric acid production, such as gastroesophageal reflux disease (GERD), peptic ulcers, and Zollinger-Ellison syndrome. Their efficacy in suppressing gastric acid secretion has made them the drug of choice in both short-term and long-term management of acid-related disorders (Maideen, 2023).
Digital Impressions Redefined: The Role of Intraoral Scanners in Modern Prosthodontics
Intraoral scanners have revolutionized the field of dentistry by providing a more efficient, accurate and patient-friendly alternative to traditional dental impressions. This article explore the advancements in intraoral scanning technology and its impact on digital impressions and restorations. Discussion It highlights the revolutionary effect these technologies have on modern dentistry, emphasizing the benefits they offer in terms of precision, effectiveness, patient experience, collaboration, integration with CAD/CAM technology and general practice success. The use of intraoral scanners into workflows in dental practices, with a focus on how these devices might improve communication between dental practitioners and laboratories and streamline procedures. Summary An intraoral scanner is a digital dental tool that captures precise 3D images of a patient's teeth and gums. It enhances diagnostic accuracy, improves treatment planning, and streamlines workflows, replacing traditional impressions with faster, more comfortable, and efficient scanning methods. Conclusion An intraoral scanners has shed light on the significant advancements and benefits that these devices bring to the field of dentistry. By improving accuracy, reducing turnaround times, and enhancing patient comfort, intraoral scanners have revolutionized the way dental professionals capture impressions and collaborate with laboratories.
The Secret Heart of Lady Chatterley: A Journey of Self-Discovery
This abstract explores the transformative journey of Lady Chatterley, a protagonist navigating the complexities of desire, identity, and societal expectations in early 20th-century England. Through her experiences, Lawrence sheds light on the tensions between social class, morality, and personal freedom, offering a nuanced portrayal of a woman's quest for self-discovery and autonomy. The novel's candid depiction of desire and intimacy challenges traditional notions of love and relationships, inviting readers to reconsider the intersections of power, identity, and human connection.
Integrating Multimedia In Anatomy: A Study On The Role Of Video Demonstration In Osteology Learning
Background: Traditional teaching techniques of osteology involving use of static models and lectures are prone to the risk of failing to impart the three-dimensional interrelationship amongst bone structures. This becomes especially challenging to the first year medical and dental learners who require to have clear knowledge of skeletal anatomy to be used in clinical practice. Aim: The study was set out to evaluate the effectiveness of instructor-narrated video demonstration as an addition to the typical osteology teaching (instructor only) to enhance student comprehension, recall and interest. Methodology: A prospective interventional study was carried out in a study population of 200 first-year MBBS and BDS students who were randomly assigned to form control (n = 100) and experimental (n = 100) groups. The conventional lectures and models of bones were used to instruct the control group; on the other hand, the experimental group was taught through the use of high-resolution video demonstrations. The results of learning outcomes were captured using pre- and post-tests, an OSPE and student-completed feedback questionnaire. Findings: The experimental group showed exceptionally greater gain in post-test with a mean gain of 30.94 as opposed to the gain of the control group which was 14.2 (p < 0.001). There was also improvement in student remarks with regard to increase in clarity, interest and comfort to revise using video based learning. Conclusion: The effect on the results of learning osteology using video demonstrations is vivid. It is proposed that multimedia tools be implanted in courses of anatomy with the idea being to facilitate more knowledge and interaction among learners.
Growing Up With Autism Spectrum Disorder: Understanding Labels, Advocacy, And Neurodiversity
This article explores the psychosocial challenges faced by individuals on the autism spectrum and their caregivers. It examines how social narratives, diagnostic labels, and advocacy efforts shape their lived experiences. Drawing on in-depth interviews with autistic self-advocates, caregivers, and practitioners, the study investigates the evolving discourse around autism, the shift from deficit-based models to neurodiversity frameworks, and the importance of inclusive practices. Findings suggest that while awareness has grown, societal stigma, ableism, and inconsistency in practitioner approaches continue to challenge autistic individuals' rights to self- definition and inclusion.
Grahani Roga And IBS: An Integrative Review Of Ayurvedic Concepts, Dietetics, And Pharmacological Management
Gastrointestinal disorders represent a substantial global health challenge, significantly impacting individuals' quality of life and imposing considerable burdens on healthcare systems worldwide. Among these, Irritable Bowel Syndrome (IBS) stands out as a highly prevalent, chronic functional gastrointestinal disorder. Global prevalence estimates for IBS vary, with figures ranging from 3% to 20% in regions like North America. When applying the Rome III or IV diagnostic criteria globally, the estimated prevalence stands at approximately 9.2%. In India, the reported incidence falls between 4.2% and 7.7%. A notable demographic pattern indicates that IBS is 2 to 3 times more common in young women compared to men, particularly within the working-age population. This widespread impact of IBS underscores the critical need for enhanced research and improved management strategies.[i] Despite the significant global prevalence of IBS and its profound effect on patient quality of life, conventional pharmacological treatments often present limitations in efficacy and are frequently associated with undesirable side effects. This situation creates a substantial gap in effective patient management, leaving many individuals seeking further relief to improve their daily living. This unmet need suggests that integrative approaches, particularly those rooted in traditional systems like Ayurveda, are well-positioned to offer valuable complementary or alternative therapies, potentially leading to more comprehensive and sustainable outcomes.[ii] [i] Alberta Health Services. (2022, February 24). Learning About the Low-FODMAP Diet for Irritable Bowel Syndrome (IBS). MyHealth.Alberta.ca Network. Retrieved from https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=acg9466 [ii] Schumann, D., Anheyer, D., Lauche, R., & Dobos, G. (2016). Effect of Yoga in the Therapy of Irritable Bowel Syndrome: A Systematic Review. Clinical Gastroenterology and Hepatology, 14(12), 1720-1729.e1. https://doi.org/10.1016/j.cgh.2016.04.026
Dementia Demystified: A Survey of Datasets, Models and Assistive Technologies
Dementia is a progressive neurological disorder that significantly impairs memory, cognition and daily functioning by affecting millions of individuals worldwide. As the global population ages there is a huge demand for early diagnosis, effective management and supportive care solutions continues to rise. This survey provides a comprehensive overview of dementia through begin with an exploration of its clinical background and common symptoms. We then examine a broad range of datasets that have been utilized in dementia related research by highlighting their characteristics, accessibility and relevance. The paper also reviews various computational and machine learning models developed for the detection and classification of dementia by discussing their methodologies along with performance and limitations. Also the paper explore a variety of assistive technologies designed to support individuals with dementia in their daily lives by including cognitive aids, monitoring systems and user friendly interfaces. By bridging clinical insights with technological advances this survey aims to guide researchers, developers and healthcare professionals toward more effective and integrated solutions for dementia care.
Effectiveness of an Awareness Programme On Knowledge and Attitude Regarding Substance Use Disorder among Adolescents
Background: Dependence to drugs and alcohol among adolescents is becoming more prevalent across the country. Adolescents are frequently the first one to experience substance abuse. It may affect their relationships, reputations, prospects, finances, self-images. Their lives are jeopardised and most importantly it may lead to deterioration of grades. Aim and Objective: The aim of the study was to evaluate the effectiveness of awareness programs on knowledge and attitude regarding substance use disorder among adolescents. Materials and Methods: Quantitative research approach with convenience sampling technique was followed to include 63 participants from St. Paul College, Moradabad. Demographic information, knowledge assessment questionnaire and attitude assessment scale on substance use disorder were used to gather data. Descriptive and inferential statistics was used for data analysis. Results: It was found that the pre-test knowledge score of the student was 18.68±5.26 and the post-test knowledge score increased to 26.54 ± 3.2, (t-value =10.567 and p=0.001) which was highly statistically significant indicating that the awareness programme was effective on knowledge regarding substance use disorder. The pre-test attitude score was found to be 21.75±4.87 which was reduced to 20.21 ± 3.16 following intervention (t - value 2.345, p=0.022) and the mean difference was statistically significant suggesting that the awareness programme is effective on attitude regarding substance use disorder. Conclusion: Substance use disorder poses a significant risk to health. In our country, adolescent specific substance use programmes are few, and research evidence regarding the effect of awareness programme on knowledge, attitude and practice is less. The Awareness Programme developed in the present study was found to be beneficial as it enhanced the adolescents' knowledge and attitudes toward substance use disorder. Hence the Awareness Programme is feasible, practical, and has significant implications for the field.
The Role of Nurses in Preventing and Managing Pressure Ulcers in Long-Term Care Facilities
Background: Pressure ulcers, or bedsores, are a significant concern in long-term care facilities (LTCFs), where residents often experience prolonged immobility and other risk factors. Nurses play a pivotal role in preventing and managing these ulcers, yet challenges such as staffing shortages and limited resources hinder optimal care. This study examines the knowledge, practices, and challenges faced by nurses in LTCFs regarding pressure ulcer prevention and management. Methods: A descriptive, cross-sectional study was conducted across three LTCFs, involving 150 nurses and 100 residents. Data were collected over three months using nurse surveys, resident medical record reviews, semi-structured interviews with nurses, and direct observations of care practices. Quantitative data were analyzed using descriptive statistics, while qualitative data underwent thematic analysis to identify key themes. Results: The majority of nurses (90%) were familiar with the Braden Scale, and 93% conducted regular skin assessments. However, only 78% were aware of the latest evidence-based practices. Among residents, 45% had pressure ulcers, with Stage II ulcers being the most common (40%). Repositioning (98%) and pressure-relieving devices (92%) were widely used and deemed effective, but challenges included insufficient staffing (80%), lack of advanced training (60%), and limited access to resources (50%). Conclusion: While nurses demonstrate strong foundational knowledge and employ effective interventions, systemic barriers such as staffing shortages and gaps in advanced training impede optimal pressure ulcer care. Addressing these challenges through enhanced education, resource allocation, and institutional support is critical to improving outcomes for LTCF residents.
Comparative Efficacy Of Corticosteroid Injections And Physical Therapy In Lateral Epicondylitis (Tennis Elbow): A Randomized Prospective Study
Background: Lateral epicondylitis (LE), commonly known as tennis elbow, is a prevalent musculoskeletal disorder stemming from the overuse of forearm extensor muscles. While corticosteroid injections offer rapid symptom alleviation, physical therapy focuses on promoting long-term tendon healing and functional restoration. Objective: This study prospectively compared corticosteroid injection and supervised physical therapy in patients with tennis elbow, evaluating pain relief, functional improvement, and recurrence rates over a 24-week period. Methods: We conducted a randomized prospective study involving 100 patients diagnosed clinically with LE. Participants were randomly assigned to either Group A (single corticosteroid injection, n=50) or Group B (supervised physical therapy protocol, n=50). Outcome measures, including the Visual Analog Scale (VAS) for pain, the Disabilities of the Arm, Shoulder and Hand (DASH) score for function, grip strength, and recurrence rates, were recorded at 4, 12, and 24 weeks post-intervention. Results: At 4 weeks, Group A demonstrated significantly superior pain relief (VAS 2.3±0.9 vs. 3.7±1.0; p<0.01). However, at 24 weeks, Group B exhibited markedly better pain and functional outcomes (VAS 1.8±0.7 vs. 4.3±1.6; DASH 17.5±4.3 vs. 34.7±6.4; p<0.001). Furthermore, the recurrence rate was significantly lower in Group B (10% vs. 36%; p<0.01). Conclusion: Corticosteroid injections provide effective short-term symptom control in lateral epicondylitis. However, physical therapy yields superior long-term outcomes with a significantly lower rate of recurrence. Therefore, physical therapy should be considered the preferred first-line treatment for lateral epicondylitis.
Pathogenic Impact of VEGF-A/VEGFR-2 Downregulation in Diabetic Microangiopathy: A Systematic Review of Renal and Neurocognitive Outcomes
Diabetic nephropathy (DN) constitutes a leading cause of end-stage renal disease (ESRD) globally, with vascular endothelial growth factor A (VEGF-A) and its primary receptor VEGFR-2 playing central roles in glomerular endothelial homeostasis. Despite the pro-angiogenic roles of VEGF-A in maintaining microvascular integrity, its aberrant regulation — especially downregulation — has emerged as a potential mechanism of renal microvascular rarefaction, capillary dropout, and progressive glomerulosclerosis in DN.Also , emerging evidence suggests that VEGF-A/VEGFR-2 downregulation in diabetes not only contributes to renal microvascular injury but also plays a pivotal role in neurovascular unit disruption and cognitive impairment. This systematic review critically appraises five exclusive high-impact studies that illuminate the consequences, mechanisms, and therapeutic implications of VEGF-A/VEGFR-2 downregulation in DN. The review emphasizes the clinicopathological trajectories associated with VEGF signaling perturbation, identifies translational targets, and integrates nephrology-specific clinical correlations.
Evaluation of Components Associated with the Complement Pathway as Potential Biomarkers for Breast Tumors
The study was designed to investigate the variations in complement system components (C1q, Properdin, C3, and C4) expression patterns among breast tumor types that are benign, malignant, and normal. Eighty samples were collected from women who attended the Early Detection of Breast Diseases Center at Al-Hussein Medical City in Karbala from 1/12/2024 to 20/12/2025. The women were examined clinically by a specialist consultant. The tissue sample was collected by fine needle aspirate or tissue biopsy, and then analyzed by immunohistochemistry to detect its type, degree of cancer, as well as the expression rate of hormones. This study used ELISA to evaluate C1q, Properdin, C3, and C4 levels in the serum of 68 female participants: ductal (n = 25), lobular (n = 8), benign (n = 18), and healthy controls (n = 17). Samples were obtained prior to treatment, stored at -20°C, and ethically approved. Age and residence showed no significant differences between groups, but BMI, socioeconomic status, and education did. Most patients were overweight and had lower socioeconomic and educational levels. Hormone receptor positivity was highest in lobular carcinomas, while ductal tumors showed more triple-negative and basal-like subtypes. C1q levels were significantly higher in ductal carcinoma, while C3 was lower in benign lesions. C4 showed no significant variation. Properdin was reduced considerably in all pathological groups compared to controls, but did not differ among them. Correlations suggested complex immune-hormonal interactions. Findings support the potential of C1q and Properdin as diagnostic markers, though not for subtype distinction.
A study to compare the level of Depression among elderly men and women in old age home.
Depression in old age is an emerging public health issue, contributing significantly to morbidity and disability worldwide. This concern is particularly prominent in the geriatric population. With the growing trend of old age homes in India, the present study was conducted to evaluate and compare levels of depression among elderly men and women residing in old age homes, and to suggest preventive or remedial measures. Objectives: The objectives of this study were: To assess the level of depression among elderly men and women residing in old age homes. To compare depression levels between elderly men and women. To determine the association between depression and selected sociodemographic variables among the elderly in old age homes. Methods: A non-experimental descriptive research design was adopted for this study titled "A study to compare the level of depression among elderly men and women in old age homes." A total of 50 elderly residents from selected old age homes were chosen using non-probability purposive sampling. Results: Among elderly women, 48% had moderate depression, 32% had mild depression, and 20% had severe depression. Among elderly men, 40% had moderate depression, 36% had mild depression, and 24% had severe depression. The mean depression scores were 8.16 for women and 7.64 for men. A paired t-test yielded a value of 8.74, which was statistically significant at the 0.05 level. There was a significant association between depression levels and sociodemographic variables such as age, religion, marital status, type of family, whether the individual had their own family, work profile before admission, reason for admission, and duration of stay in the old age home. Conclusion: The study concludes that a higher percentage of elderly women in old age homes experience moderate levels of depression compared to men. These findings emphasize the need for targeted mental health interventions and support systems tailored to the elderly, particularly women, in institutional settings.
Medical Students and Substance Abuse: Exploring the Scope and Repercussions - A Cross Sectional Study
Substance abuse among medical students is an emerging public health concern, potentially impacting academic performance, mental well-being, and future clinical practice. Understanding the extent and consequences of substance use in this population is crucial for early intervention and developing a course of action for prevention and support Objective: To assess the prevalence of substance abuse and examine its psychological, academic, and social repercussions among medical students in a medical college in South Delhi Methods: A cross-sectional study was conducted among 200 undergraduate medical students using a structured, anonymous questionnaire. Out of 200, 182 responded. The survey collected data on demographic details, types and frequency of substances used, reasons for use, and perceived impacts. Statistical analysis was performed to identify significant associations between substance use and various academic and psychosocial factors. Results: Out of the total participants (N = 182), 71 or 39 % reported current or past use of at least one psychoactive substance, with alcohol and cannabis being the most commonly used. A significant proportion cited stress relief, peer pressure, and academic burden as key motivators. Substance use was found to correlate with decreased academic performance, poor sleep quality, and higher levels of anxiety and depression (p < 0.05). Conclusion: The study highlights a concerning prevalence of substance abuse among medical students and underscores its negative implications on academic and mental health outcomes. There is a pressing need for awareness programs, counselling services, and institutional support systems to address this issue within medical education environments.
Study Of Perceived Discrimination, Social Support, Anxiety, And Depression In Patients With Gender Dysphoria
The study aimed to assess the levels of perceived discrimination, social support, anxiety, and depression among patients with gender dysphoria and to explore the associations between these factors. Materials and Methods: A cross-sectional study was conducted over 12 months at S.S.G. Hospital, Vadodara, including 40 patients aged 18–45 years diagnosed with gender dysphoria as per DSM-5 criteria. Perceived discrimination was assessed using the DISC-12, social support with the MSPSS, and severity of anxiety and depression with the HAM-A and HAM-D scales, respectively. Data analysis was performed using MedCalc and Epi Info 7.1, with a p-value <0.05 considered significant
Psychosocial And Reproductive Health Impacts Of War-Driven Displacement On Adolescent Girls In Port Sudan (2023–2025): A Cross-Sectional Study
Adolescent girls displaced by armed conflict face compounded risks to their mental and reproductive health. In Port Sudan, mass displacement between 2023 and 2025 created acute humanitarian conditions, prompting this study's investigation into trauma-related menstrual challenges. Objectives: To examine the prevalence and severity of psychosocial trauma and its correlation with menstrual and reproductive health disturbances among displaced adolescent girls. The study further explores sociodemographic modifiers influencing these outcomes.
Content Validation of the Handwriting Difficulties Screening Checklist for individuals with Autism Spectrum Disorder (HDSC-ASD) as per RPWD Act 2016.
The purpose of this study was to evaluate the content validity of the Handwriting Difficulties Screening Checklist for Autism Spectrum Disorder (HDSC-ASD), a screening tool designed to assess handwriting challenges in individuals with Autism Spectrum Disorder (ASD) as per RPWD Act 2016. The checklist consists of ten domains reflecting core aspects of handwriting performance. A panel of experts in occupational therapy, special education, and developmental disorders reviewed the tool for relevance, clarity, and representativeness. Content validity was assessed using the Item Content Validity Index (I-CVI) and Scale Content Validity Index (S-CVI/Ave). The results supported strong content validity for the tool, with all items achieving acceptable I-CVI values and an overall S-CVI/Ave of 0.92. These findings suggest that HDSC-ASD is a content-valid tool for screening handwriting difficulties in individuals with ASD.
Correlation Of Corrected QT Interval With Quantitative Cardiac Troponin I Levels And Its Prognostic Role In Non ST Elevation Myocardial Infarction
Presence of different risk groups in non-ST-elevation acute coronary syndrome (NSTE-ACS), indicate the need for new tools to perform early diagnosis and prognostic stratification. In this sense, it has been shown that the corrected QT interval prolongation is an independent risk marker in NSTE-ACS with or without acute ischemic changes. of this study is to assess the correlation between prolongation of corrected QT interval and cardiac Troponin I in prognosis of patients with Non ST elevation Myocardial Infarction.
The Role of Physical Therapy in Improving Movement and Balance in Children with Cerebral Palsy; Systematic Review
Cerebral palsy (CP) significantly impairs movement and balance in children. Physical therapy (PT) is a foundational approach to managing motor deficits, yet there remains variability in evidence regarding its effectiveness. Objective: This systematic review aims to evaluate the role of various physical therapy interventions in improving movement and balance among children with CP. Methods: A systematic search was conducted across databases including PubMed, Google Scholar, and Scopus for studies published between 2005 and 2023. Studies were selected based on relevance to PT interventions in children with CP. Only quantitative studies were included. Risk of bias was assessed using PEDro and JBI tools. Data extraction focused on intervention type, outcome measures, and functional improvements. Results: Twenty studies met inclusion criteria, including randomized controlled trials, quasi-experiments, pilot studies, and systematic reviews. Traditional therapies such as neurodevelopmental therapy and task-specific training improved gross motor function. Technology-driven interventions, particularly Wii-based therapy and serious games, showed substantial improvements in dynamic balance and engagement. Early intervention, core training, and biofeedback-supported strategies produced significant gains in posture and gait regulation. Conclusions: Physical therapy remains essential in pediatric CP rehabilitation, especially when therapy is initiated early and involves interactive, balance-focused tasks. Multimodal and engaging interventions appear to yield superior functional outcomes. Future research should aim for standardization in protocols and outcomes.
Advances in Early Detection and Management of Pediatric Sepsis in Pediatric Emergency Departments: Systematic review"
Pediatric sepsis remains a critical cause of morbidity and mortality in emergency departments (ED) worldwide. Early detection and the prompt initiation of treatment—particularly the timely administration of antibiotics—are essential to improving outcomes in this vulnerable population.
Efficacy Of Olanzapine V/S Haloperidol In Treating Delirium In Intensive Care Settings – A Comparative Study From Southern Rajasthan.
Background: Delirium is a common yet often under diagnosed entity in medical and surgical intensive care (ICU) settings. Being a preventable and potentially reversible condition, the early recognition and optimal treatment of delirium is of vital importance in preventing its potential mortality. The FDA has approved haloperidol as well as olanzapine for treating ICU psychosis (delirium). This study aims to compare the efficacy of both drugs in treating ICU psychosis, while exploring their comparative safety profiles. Methodology: A total sample population of 100 ICU patients diagnosed with delirium was recruited in the study and randomly divided in two treatment groups – haloperidol and olanzapine, after excluding delirium due to alcohol withdrawal (delirium tremens). Maximum dose of haloperidol administered was 2.5 mg/day (oral or parenteral) and of olanzapine was 5 mg/day. After taking consent from patient’s family member, the Delirium Screening Checklist, Delirium Rating Scale and Richmond Agitation Sedation Scale were applied in suspected delirium cases to record delirium severity score at zero hour. After drug administration, the scoring was repeated at 72 hours. Patient demographics and relevant clinical variables, along with any adverse drug effects were also recorded for further analysis. Results: Severity of delirium significantly reduced in both treatment groups, regardless of underlying cause or comorbidity. Adverse drug effect of extrapyramidal signs was more seen with the use of haloperidol as compared to olanzapine. The underlying illness and dose of medication did not have a significant correlation with the extent of treatment response in both groups. Conclusion: Adding to existing literature, this study reiterates that efficacy of both antipsychotics (typical – haloperidol and atypical – olanzapine) does not significantly differ in the treatment of delirium in ICU settings. The use of olanzapine seems to be overall safer as compared to haloperidol.
Development Of Dental Arches: Efficacy Of Aligners In Mixed Dentition (Retrospective Study)
Introduction : The development of dental arches and the interception of transverse discrepancies in mixed dentition are essential for balanced facial growth. While conventional interceptive devices are highly effective, they have limitations in acting teeth and arches simultaneously. Today, the use of clear aligners has emerged as an alternative that may overcome these limitations. Our study aims to evaluate the clinical effectiveness and predictability of aligners in the development of dental arches in patients with mixed dentition. Method : A retrospective clinical study was conducted on 19 young patients in the mixed dentition phase who underwent early treatment with clear aligners. The quantity of maxillary expansion was analyzed in both the anterior and posterior regions to assess the effectiveness and predictability of the aligners. Additionally, we examined the various sagittal and vertical malocclusions, as well as dental misalignment, that were corrected in parallel with arch development Result: The analyses show significant arch development, with the highest score in the anterior region. Harmonization of dental arches was observed and significative changes in dental misalignments and malocclusions Discussion : Clear aligners appear to be a promising option for arch development in mixed dentition. Although their effectiveness depends on several factors, including digital planning of tooth movements and patient compliance, this approach offers improved comfort and reasonable treatment durations. Further studies are needed to optimize protocols and enhance the predictability of outcomes. Conclusion : This retrospective study provides an opportunity to explore the clinical outcomes achieved with clear aligners, which could contribute to their use in the field of early interceptive orthodontics
Towards A Sustainable Community Mental Health Program: Understanding Its Manpower Needs And Building Its Workforce Strategy
In program management, manpower is considered as one of the fundamental resources and aspects to consider for successful execution. The manpower needs are crucial for understanding and managing operational efficiency and program sustainability and outcomes. One of the important health initiatives of the Philippine government in recent years is the community mental health program. This has been rolled out since 2019 in Region IVA, Philippines (also known as CALABARZON). This highlights the referral pathway between primary health care centers and mental health facilities for the management of persons with mental health conditions. Based on the review of its initial implementation, this initiative has able to achieve an estimated 11% cost-saving on the government’s expenditures on mental health. To sustain this successful result, this study has been conceived with the objectives of determining the program’s manpower needs and of recommending actions to address any gaps for a more sustainable quality management of this community mental health program There are 409 healthcare workers assigned in this program who were part of the study. The majority of them are female and bachelor graduates, whose ages range from 31-40 years old. The manpower needs of the program include proper training, a good incentive scheme, and higher pay for healthcare workers. As such, the study proposed two approaches: (1) supporting the continuous competence training and capability building initiatives, and (2) developing incentive- payment schemes for the community mental health workers
Migraine Patterns During Pregnancy and Postpartum: A Prospective Cross-Sectional Study
Background: Migraine is a common neurological disorder, particularly among women of reproductive age. Pregnancy and the postpartum period involve hormonal, physiological, and lifestyle changes that may influence the onset, frequency, and severity of migraine attacks. Understanding migraine patterns and management strategies in this population is essential for optimizing maternal and fetal outcomes. This study investigates the clinical features, triggers, and treatment approaches of migraine among pregnant and postpartum women attending a tertiary care hospital. OBJECTIVES: To assess the frequency, severity, triggers, and treatment practices of migraine among pregnant and postpartum women attending a tertiary care hospital. METHODS: A prospective cross-sectional observational study was conducted over a three-month period (April to June 2025) in the Department of Obstetrics and Gynaecology at Varun Arjun Medical College and Rohilkhand Hospital, Shahjahanpur. A total of 40 participants clinically diagnosed with migraine were enrolled. Data were collected using structured proformas and face-to-face interviews. Descriptive analysis was performed using frequency and percentage distribution for demographic, clinical, and treatment-related variables. RESULTS: The 25–30 years age group was most common (n=18, 45%). Primigravida women accounted for 55% (n=22). Migraine episodes occurred most frequently in the postpartum period (n=14, 35%) and third trimester (n=12, 30%). Moderate severity was observed in 18 participants (45%), severe in 16 (40%), and mild in 6 (15%). Sleep deprivation was the most reported trigger (n=22, 55%), followed by emotional stress (n=19, 47.5%) and hormonal fluctuations (n=16, 40%). Paracetamol was used by 25 women (62.5%), non-pharmacological methods by 20 (50%), and triptans by 1 (2.5%). Preterm delivery was observed in 5 participants (12.5%), low birth weight in 3 (7.5%), and NICU admission in 2 (5%). No complications occurred in 30 cases (75%). CONCLUSIONS: Migraine during pregnancy and postpartum is commonly moderate to severe and predominantly triggered by sleep and stress-related factors. Early recognition and tailored management can support better maternal and fetal outcomes.
Retrospective evaluation of Transfusion Transmissible infections in Discarded Blood Units: A 5-year analysis from a regional Blood Centre at Bundi, Rajasthan
This study retrospectively analyses data on discarded blood units due to positivity for Transfusion-Transmissible infections (TTIs) at Regional Blood Centre of Pt. B.S. Sharma General Hospital, Bundi, Rajasthan, from January 2020 to December 2024. The objective was to determine the prevalence and trends of HIV, HCV, HBsAg, VDRL (syphilis), and Malarial Parasite (M.P.) among discarded donated blood units. Data were sourced from the Blood Centre annual discard reports. Over the five years, a total of 38,678 blood units were collected, with 1,031 units (2.67%) discarded due to TTI positivity. Hepatitis B surface antigen (HBsAg) was the most common reason for discarding units, accounting for 825 discard units (80.02%of all discards, 2.13% of total collections). The number of HIV-positive discards were 32, HCV was 37, VDRL was 134, and Malaria Parasite was 3. This emphasizes the critical need for robust and sustained screening protocols, while also identifying key areas for focused public health interventions to lower the burden of transfusion-transmitted infections (TTIs) in the donor population. These efforts are in alignment with both national and global strategies aimed at ensuring the highest standards of blood safety.
Effectiveness of Robotic Therapy in Improving Balance Function After Stroke: Systematic Review
Background: Balance impairment is a prevalent and debilitating consequence of stroke that contributes to falls, reduced mobility, and limited independence. While robot-assisted gait training (RAGT) has shown promise in improving motor outcomes post-stroke, its specific impact on balance remains unclear. This systematic review and meta-analysis aims to evaluate the efficacy of RAGT on balance function in adult stroke patients, and to identify potential moderators such as stroke chronicity, robotic device type, and training intensity. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, and CNKI for randomized controlled trials (RCTs) from inception through January 2020. Studies were included if they compared robotic gait therapy to conventional therapy and assessed balance outcomes using validated tools (e.g., Berg Balance Scale, Timed Up and Go). Data extraction, quality assessment (via RoB 2), and meta-analyses (random-effects model) were performed. Subgroup analyses evaluated the effects of stroke stage (acute/subacute vs. chronic), device type (exoskeleton vs. end- effector), and therapy dose (≥10 vs. <10 total hours). Results: Twenty-five RCTs involving 1,362 participants were included. Pooled results demonstrated that RAGT significantly improved balance compared to conventional therapy (BBS mean difference = 3.58; 95% CI: 1.89–5.28; p < 0.001). Subgroup analysis revealed greater benefits in acute/subacute patients (MD = 5.40) and with exoskeleton devices. Training intensity was a significant moderator, with protocols ≥10 total hours yielding superior outcomes. No major adverse events were reported. Conclusion: Robot-assisted gait training is effective in enhancing balance function in stroke survivors, particularly in the early recovery phase and when using exoskeleton systems with sufficient training intensity. While not universally superior to conventional therapy, RAGT represents a viable and safe strategy for targeted balance rehabilitation. Further long-term and cost- effectiveness studies are warranted.
Hadeel Yahya Almushayikh PT, CLT, CDNP, COMT
The Role of Ultra-High-Resolution Magnetic Resonance Imaging (UHD-MRI) In the Early Detection of Neurodegenerative Diseases: Systematic Review
Background: Early detection of neurodegenerative diseases such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and multiple sclerosis (MS) remains a major clinical challenge. Conventional neuroimaging often fails to capture subtle anatomical changes at the preclinical stage. Ultra-high-resolution magnetic resonance imaging (UHD-MRI), especially at field strengths of 7 Tesla (7T) or higher, presents new opportunities for early diagnosis. Objectives: This systematic review aimed to synthesize recent evidence on the diagnostic utility of UHD-MRI in identifying early structural and functional brain changes associated with neurodegenerative diseases. Methods: Following PRISMA 2020 guidelines, we searched five databases and included peer-reviewed human studies published between 2010 and 2024. Studies were screened for use of UHD-MRI (≥7T) and relevant neurodegenerative outcomes. A narrative synthesis was conducted based on imaging resolution, anatomical targets, diagnostic performance, and integration with adjunct technologies. Results: A total of 15 studies met inclusion criteria. UHD-MRI consistently demonstrated superior anatomical resolution, improving detection of hippocampal subfields, cortical laminae, and deep brain nuclei. Sensitivity improvements ranged from 15–30% over 3T MRI. Integration with AI and PET further enhanced diagnostic accuracy, while automated segmentation reduced operator variability. Conclusion: UHD-MRI offers substantial improvements in detecting early pathological changes in neurodegenerative diseases. Its combination with AI-driven analysis and hybrid PET approaches holds promise for future diagnostic frameworks, though issues of accessibility, cost, and standardization remain.
Impact of health professionals' nutrition education on pregnant women's awareness of pregnancy-specific nutrition and adoption of healthy eating habits
Background Proper nutrition during pregnancy is essential for maternal health and fetal development. Inadequate dietary intake is associated with adverse outcomes such as anemia, low birth weight, preterm birth, and inadequate maternal weight gain. Despite the importance of maternal nutrition, many pregnant women have limited knowledge about proper dietary practices due to cultural beliefs, lack of information, and inconsistent healthcare counseling. This study aimed to evaluate the impact of health professionals' nutrition education on pregnant women’s awareness and dietary practices. Methods A facility-based, single-group pre–post quasi-experimental study was conducted over three months, with 200 pregnant women in their first and second trimesters. Stratified random sampling was used to select participants from antenatal care (ANC) clinics. The intervention involved structured nutrition education delivered by trained health professionals through counseling sessions, printed materials, and self- study leaflets. Data on nutritional knowledge and dietary practices were collected using a structured questionnaire at three points: pre-intervention, immediately post- intervention, and six weeks later. Paired t-tests and repeated-measures ANOVA were used for statistical analysis. Results Participants demonstrated a significant improvement in nutrition knowledge, with mean knowledge scores increasing from 5.2 (SD: 1.4) pre-intervention to 9.8 (SD: 1.0) immediately after the intervention and 9.6 (SD: 1.2) at six weeks follow-up (p < 0.001). Dietary practices also improved; adherence to iron supplementation increased from 40.0% to 93.3%, while daily meal intake and fruit/vegetable consumption rose from 60.0% and 50.0% to 98.3% and 96.7%, respectively. Women with higher education and frequent ANC visits exhibited greater knowledge retention. Conclusion: The study highlights the effectiveness of structured nutritional education in improving pregnant women’s knowledge and dietary habits. Integrating nutrition education into ANC services can enhance maternal health and fetal outcomes. Future research should assess the long-term impact on birth outcomes and explore scalable interventions to improve maternal nutrition at a national level.
The Effectiveness of Artificial Intelligence and Robotics-Based Physical Therapy in Rehabilitating Stroke Patients
Background: Stroke remains a leading cause of long-term disability, necessitating innovative rehabilitation approaches. Artificial intelligence (AI) and robotics-based physical therapy have emerged as promising interventions to enhance motor recovery, balance, and functional independence in stroke patients. This systematic review and meta-analysis evaluates the efficacy of these technologies compared to conventional rehabilitation methods. Methods: Ten randomized controlled trials (RCTs) and proof-of-concept studies published between 2020 and 2025 were included. Studies assessed AI and robotic interventions, such as exoskeletons, brain-computer interfaces (BCIs), and adaptive robotic systems, focusing on outcomes like Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), and gait metrics. Data were extracted by independent reviewers, and meta-analyses were conducted using random-effects models to pool mean differences (MD) with 95% confidence intervals (CI). Heterogeneity was assessed via the I² statistic, and risk of bias was evaluated using the Cochrane ROB tool. Results: The meta-analysis revealed significant improvements in motor function (FMA: MD = 4.36, 95% CI: 2.46–6.26, p < 0.05) and balance (BBS: MD = 7.18, 95% CI: 4.79–9.57, p < 0.05) favoring robotic and AI-assisted interventions. Notable findings included the superiority of BCI training with exoskeleton feedback (12.77% improvement in FMA-UE) and adaptive systems like ROBiGAME (r = 0.84 for task adaptation). Telerehabilitation studies showed mixed outcomes, with robotic interventions excelling in mood improvement but lagging in motor gains compared to non-robotic approaches. Heterogeneity was low (I² < 25%), and most studies had low risk of bias. Conclusion: AI and robotics-based rehabilitation significantly enhance motor and functional recovery post-stroke, offering personalized, scalable, and data-driven solutions. Future research should standardize protocols, address cost barriers, and explore long-term outcomes to facilitate clinical adoption. These technologies represent transformative adjuncts to traditional therapy, promising better recovery paradigms for stroke survivors.
Saeed Mohammed Alasmari, PT, OMTC, CKTP, IASTM
A Prospective Comparative Study of Clinicoradiological and Functional Outcome of Intertrochanteric Fractures Treated with Proximal Femoral Nail as Against Proximal Femoral Nail-A2
Background: Stable fixation is necessary for the best recovery from intertrochanteric fractures, which are common in the elderly. Although both the Proximal Femoral Nail (PFN) and its variant, the Proximal Femoral Nail A2 (PFN A2), are commonly used implants, there are currently few studies comparing their results and our study aims to evaluate the clinic-radiological and functional outcomes of intertrochanteric fractures treated with Proximal Femoral Nail versus Proximal Femoral Nail A2. Methodology: A comparative study was conducted among 60 patients with each group includes 30 intertrochanteric patients and treated with PFN & PFNA 2 at tertiary hospital in Kuppam. Clinical outcomes were assessed using parameters such as duration of surgery, blood loss. Radiological union was evaluated through follow-up X-rays. Functional outcomes were measured using the Harris Hip Score (HHS) at regular intervals postoperatively. Results: PFN A2 group achieved a higher mean MHHP score and superior long-term functional outcomes, while maintaining better anatomical alignment and lower Tip apex distance, indicating improved fracture reduction stability and reduced complication risks, compared to the PFN group. On comparing two groups we found significant MHHP Score at 3 & 6 months, Neck shaft angle and Tip apex distance (p<0.05). No significant difference was observed between the two groups in the duration of union. Conclusion: With minor variations in surgical and early postoperative parameters, PFN and PFN A2 both yield satisfactory results for intertrochanteric fractures. The surgeon's preference and the fracture pattern may influence the implant selection. Additional long-term research is required to confirm these results.
A Comparative Study of Condylar Head Dimensions Effects of Gender, Age, and Side Differences
Condylar processes of the mandible are the major components of the temporomandibular joint (TMJ) with great intersubject variability in size and shape. This study uses cone-beam computed tomography (CBCT) to assess the effect of sex, chronological age, and side on the mediolateral dimension and vertical height of the condylar head. A good understanding of condylar head measurements is crucial to the diagnosis and treatment of TMJ disorders because morphometric differences may affect the position of the mandible and its dynamics of functioning. Understanding sex, age, and laterality related roles in these dimensional alterations would allow for reworking of treatment modalities and increased accuracy in presurgical planning, which in turn could result in a better patient outcome. The study included fifty CBCT scans, with an equal split between each gender (twenty-five males and twenty-five females) aged twenty to forty years obtained from the radiology records at the Specialty Dental Center in Baquba city, Diyala, Iraq. Mediolateral width and vertical height of the condylar head were taken from the coronal CBCT scan slices and the data were categorized by age group; sex; and the lateral side, right or left. Statistical analyses reported independent-samples t-test, one-way ANOVA and Cohen’s d to express effect magnitudes. There was no significant sex effect on condylar width (p = 0.319 right; p = 0.710 left) or height (p = 0.492 right; p = 0.079 left), as shown by the results. However, age was significantly related to differences in mediolateral width (p = 0.026 right; p = 0.016 left) but not with vertical height (p = 0.888 right; p = 0.216 left). A substantial side-to-side asymmetry was not revealed in boys and girls for width (p = 0.844) and height (p = 0.876) with small effect size (Cohen’s d = 0.0199–0.0433). In conclusion, gender and side do not significantly influence the dimensions of the condylar head, as far as the measurement of condylar head is concern, whereas age does influences the mediolateral width but not with the vertical height. This information is essential to the knowledge of condylar morphology and the diagnosis and treatment planning of TMJ disorders.
Prevalence of Polypharmacy and Its Impact on Hospital Readmission in Elderly Patients
Background: The aging population in Saudi Arabia faces significant healthcare challenges, including the management of multiple chronic conditions through polypharmacy. While polypharmacy is often necessary, inappropriate use can lead to adverse outcomes such as increased hospital readmissions. This study aimed to determine the prevalence of polypharmacy among elderly patients in Saudi Arabia and evaluate its impact on 30-day hospital readmission rates. Methods: A retrospective observational study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia, involving 420 elderly patients aged 65 years and older discharged between January and December 2023. Polypharmacy was defined as the prescription of five or more medications at discharge. Data were extracted from electronic medical records, including demographic details, medication counts, and readmission status within 30 days. Statistical analyses included descriptive statistics, Chi-square tests, and logistic regression to assess associations. Results: The prevalence of polypharmacy was 55.7% (234/420 patients). The overall 30-day readmission rate was 25.7%, with significantly higher readmission rates among polypharmacy patients (33.8%) compared to those with fewer medications (15.6%). A strong association was found between polypharmacy and readmission (p < 0.001), even after adjusting for confounders. Conclusion: Polypharmacy is highly prevalent among elderly patients in Saudi Arabia and is strongly associated with increased hospital readmissions. These findings highlight the need for targeted interventions, such as medication reviews and improved discharge planning, to mitigate risks and enhance patient outcomes. Addressing polypharmacy through evidence-based strategies is essential for reducing preventable readmissions and optimizing geriatric care.
Assessing the Impact of Public Health Campaigns on Smoking Cessation Rates
Background: Public health campaigns are a cornerstone in addressing tobacco use, aiming to inform, motivate, and support individuals in quitting smoking. Despite their widespread implementation, challenges such as relapse rates and disparities in access to cessation resources persist. This study assesses the impact of public health campaigns on smoking cessation rates, focusing on campaign exposure, behavioral responses, and demographic variations. Methods: A quantitative cross-sectional study was conducted among 384 adults aged 18 and above, comprising current smokers and recent quitters. Participants were selected via stratified random sampling from urban and suburban settings. Data were collected using structured questionnaires, covering demographics, smoking history, campaign exposure, and cessation behavior. Statistical analyses, including chi-square tests and logistic regression, were performed to evaluate associations between campaign exposure and quitting outcomes. Results: The majority of participants (77.6%) reported being motivated to quit due to campaign exposure, with television/radio being the most common medium (55.2%). However, only 29.2% utilized support services, and 38.5% successfully quit smoking. Relapse rates among quitters were 24.5%. Younger, educated, and urban participants showed higher responsiveness to campaigns. Repeated exposure to messages significantly correlated with increased motivation to quit. Conclusion: Public health campaigns effectively motivate smoking cessation but face limitations in sustaining long-term abstinence and connecting individuals with support services. To enhance impact, campaigns should integrate continuous messaging, tailored interventions for vulnerable groups, and stronger linkages to cessation resources. A multi-dimensional approach combining media efforts with policy and infrastructure support is essential for lasting public health gains.
Evaluating the Use of Telemedicine in the Diagnosis and Treatment of Ear Infections: A Systematic Review
Background: Otitis media is a major global health concern, particularly among children, with significant implications for hearing loss and development. Access to timely and accurate diagnosis remains a challenge in low-resource and rural settings. Telemedicine has emerged as a potential solution, offering digital diagnostic and care delivery pathways for ear infections. Objectives: To systematically evaluate the evidence on the effectiveness, diagnostic accuracy, and implementation of telemedicine in diagnosing and managing ear infections, including acute otitis media (AOM), otitis media with effusion (OME), and chronic suppurative otitis media (CSOM). Methods: A systematic review was conducted according to PRISMA 2020 guidelines. Searches were performed across PubMed, Web of Science, Scopus, Embase, and Google Scholar for studies published between 2005 and 2025. Inclusion criteria encompassed peer-reviewed articles evaluating telemedicine interventions (e.g., video otoscopy, AI tools, remote consultation) for ear infections. Data were synthesized narratively due to heterogeneity in methods and outcomes. Results: Fifteen studies were included: 6 diagnostic validation studies, 2 RCTs, 3 systematic reviews/meta-analyses, and others. Telemedicine interventions demonstrated high diagnostic accuracy (sensitivity up to 97%), reduced follow-up delays, and comparable outcomes to in-person care. Community-based and AI-assisted programs were particularly effective in pediatric and underserved populations. Cost savings and improved access were reported in multiple studies. Conclusion: Telemedicine is a reliable and scalable approach for diagnosing and managing ear infections. When supported by appropriate infrastructure and training, it offers significant benefits in equity, efficiency, and clinical care, especially in remote and low-resource environments.
Psychosocial support in primary caregivers of children with autism: An empowerment-based approach
The world of autism spectrum disorders (ASD) spans a complex and multidimensional environment that places demands on the diagnosed category with the illness and their family. This study aims to provide a thorough understanding of the psycho-social support, focusing on its importance and difficulties. The current study adopted a descriptive research in combination with census sampling. The site for this investigation was Tiruchirappalli, TN, wherein the agency "Siirugughal" operates to rehabilitate and provide skill training to adolescents with autism. The Multidimensional Perceived Social Support Scale (MSPSS) was used to learn the extent of support faced by the caregivers. The study group involves 36 primary caregivers who have a son, daughter, or sibling of children diagnosed with ASD. These methods improve the overall standard of support and care provided to adolescents with autism, which benefits both parties and benefits the caregivers themselves. Point in out the significance of psychosocial support to the parents of ASD children. The empowerment-based approaches and social support strengthen them with knowledge, skills, and resources to effectively fulfil their caregiving roles.
The Clinical Impact of SGLT2 Inhibitors in Patients with and without Type 2 Diabetes: Systematic Review
Background: Sodium-glucose co-transporter-2 (SGLT2) inhibitors have demonstrated significant benefits in reducing cardiovascular events and delaying kidney disease progression in patients with type 2 diabetes, heart failure, or chronic kidney disease (CKD). However, their impact on non-diabetic populations remains less explored. This systematic review aimed to evaluate the effects of SGLT2 inhibitors in patients with and without type 2 diabetes. Methods: A comprehensive literature search was conducted using MEDLINE and Embase databases up to September 5, 2022. Randomized, double-blind, placebo-controlled trials with at least 500 participants per arm and a minimum follow-up of six months were included. Primary outcomes were kidney disease progression, acute kidney injury (AKI), and composite cardiovascular outcomes. Data were analyzed using inverse-variance weighting to derive summary relative risks (RRs) with 95% confidence intervals (CIs). Results: The analysis included 13 trials with 90,413 participants. SGLT2 inhibitors reduced the risk of kidney disease progression by 37% (RR 0.63, 95% CI 0.58–0.69) and AKI by 23% (RR 0.77, 95% CI 0.70–0.84), with consistent benefits observed in both diabetic and non-diabetic populations. Cardiovascular death or heart failure hospitalization was reduced by 23% (RR 0.77, 95% CI 0.74–0.81). Safety outcomes included a higher risk of diabetic ketoacidosis (RR 2.12, 95% CI 1.49–3.04) and limb amputations (RR 1.15, 95% CI 1.02–1.30) in diabetic patients, but no significant risks were noted in non-diabetic individuals. Conclusion: SGLT2 inhibitors provide significant renal and cardiovascular benefits across diverse patient populations, irrespective of diabetes type II status. These findings support their broader use in managing CKD and heart failure, though careful monitoring for adverse effects is warranted in diabetic patients.
The Role of Primary Care in Improving Type 2 Diabetes Management: A Family Medicine Approach
Background: Type 2 diabetes mellitus (T2DM) is a global public health challenge, with rising prevalence and significant economic and social burdens. Primary care, particularly family medicine, plays a pivotal role in early detection, continuous monitoring, and preventive strategies for T2DM management. This study examines the effectiveness of a family medicine approach in improving diabetes outcomes through structured interventions, patient-centered care, and multidisciplinary support. Methods: A quantitative, descriptive cross-sectional study was conducted in primary care clinics, involving 250 adult patients with T2DM. Data were collected using structured questionnaires and electronic medical records, focusing on demographic and clinical characteristics, treatment adherence, lifestyle behaviors, and patient perceptions of family medicine care. Statistical analyses included descriptive and inferential methods to evaluate associations between variables such as glycemic control (HbA1c <7%) and follow-up frequency. Results: The majority of participants were aged 45–59 years (49%), with balanced gender distribution (51% male, 49% female). Only 32% achieved good glycemic control (HbA1c <7%), while comorbidities like hypertension (63%) and high cholesterol (55%) were prevalent. Medication adherence was moderate (69% never/rarely missed doses), but lifestyle behaviors were suboptimal (39% followed a diet plan, 33% engaged in regular exercise). Most patients (56%) reported clear communication from physicians, and 61% received lifestyle counseling. High satisfaction (84%) and perceived control (80%) were noted, with 85% recommending family medicine for diabetes care. Conclusion: Family medicine-based interventions demonstrate strengths in patient communication and satisfaction but highlight gaps in glycemic control and lifestyle adherence. The findings underscore the need for enhanced individualized care, structured lifestyle counseling, and systemic improvements to optimize T2DM management in primary care settings. Future strategies should focus on strengthening multidisciplinary collaboration and addressing barriers to improve diabetes outcomes.
“Colorectal Cancer Incidence in Saudi Arabia: The Role of Surgery in Survival Rates”
Background: Colorectal cancer (CRC) is a major global health concern and ranks among the top three most common malignancies in Saudi Arabia. Despite advances in treatment, CRC survival rates in the Kingdom remain suboptimal due to late-stage diagnoses, disparities in surgical care access, and inconsistent treatment quality. Surgery remains the primary curative intervention, yet its role and impact on survival outcomes in the Saudi context require comprehensive evaluation. Objectives: This systematic review aims to synthesize existing evidence on colorectal cancer incidence trends, surgical outcomes, barriers to timely surgical care, and regional disparities in Saudi Arabia. The goal is to assess how surgical interventions influence CRC survival rates and inform national healthcare strategies. Methods: A systematic review of peer-reviewed literature and gray sources was conducted following PRISMA guidelines. Databases searched included PubMed, Embase, Scopus, Web of Science, and the Saudi Digital Library, alongside local sources such as the Saudi Cancer Registry and Ministry of Health reports. Studies from 2013 to 2023 focusing on CRC in Saudi Arabia were included. Data extraction encompassed demographics, staging, surgical outcomes, barriers, and regional variations. Quality assessment employed the Newcastle-Ottawa Scale and Joanna Briggs Institute (JBI) checklist. Narrative synthesis and thematic analysis were conducted. Results: Twenty studies met the inclusion criteria. CRC incidence in Saudi Arabia has significantly increased, with a predominance of advanced-stage diagnoses. Surgical intervention, particularly timely and minimally invasive surgery, was consistently associated with improved survival outcomes. However, disparities in access to surgical care, especially in peripheral regions, and socio-cultural barriers impeded optimal treatment delivery. Emergency surgeries were linked to higher mortality rates. Public healthcare institutions demonstrated superior outcomes compared to private sectors. Emerging biomarker-driven surgical approaches showed promise for personalized treatment. Conclusions: Surgical intervention plays a pivotal role in improving CRC survival rates in Saudi Arabia. Addressing systemic barriers, enhancing surgical infrastructure, and implementing nationwide screening programs are essential for improving outcomes. Policy alignment with Saudi Vision 2030 is crucial to ensure equitable access and standardization of care.
Study Of Attitude Towards Treatment And Factors Affecting Compliance In Patients With Schizophrenia
Antipsychotic medications are crucial for treating schizophrenia, but non-compliance is a significant issue. Understanding patient attitudes and reasons for non-compliance is key to improving treatment adherence. Study findings show that 40.3% non-compliance rate; higher PANSS scores and poor insight linked to non-compliance. Negative attitudes (DAI-10 scores) correlated with higher non-compliance. ROMI scale indicated better compliance if patients felt treatment benefits, had positive family support, or a good clinician relationship. Educating patients and families about treatment options can improve compliance.
ENT manifestations of Covid-19 patients: A hospital based study:
Objectives: To study & discuss the different Ear Nose & Throat (ENT) manifestations of laboratory confirmed Covid positive patient reported in TRIHMS Hospital.
Knowledge, attitude and practice of pharmacovigilance among paramedics and non-medical personnel in a newly opened tertiary care center
Background: When a drug is taken a risk is taken. Medicinal products are essentially used for beneficial purposes but it may also carry some anticipated side effects, sometimes it could be undesirable and unexpected. The associated risks are significantly reduced with its judicious use i.e recommended dose in a proper dosage form. However there are instances when optimal dose have caused adverse drug reactions ranging from mild to life threatening conditions bring human sufferings in terms of morbidity and mortality, as well as economic burden to the health care system. Assessment of knowledge attitude and practice regarding pharmacovigilance among the medical personnel and the non medical working staff can possibly give us insight in the understanding of various internal and external factors affecting reporting of ADRs. There is a possibility to figure out the lacunae where necessary intervention may be required to address the related issues, as some studies have suggested that lack of knowledge may lead to non-judicious use of medicines and it is concerning. Objective: The study was undertaken to assess the knowledge, attitude and practice of pharmacovigilance among paramedics and non-medical personnel in a newly opened tertiary care center. Methods: A cross-sectional study was designed using a self-administered questionnaire to access the knowledge, attitude and practice of pharmacovigilance among the participants from paramedics and non-medical personnel of Kokrajhar medical college and hospital administration. Results: A total of 150 participants from paramedics and non medical personnel have completed the questionnaire. 31% of the paramedics and 26 % of the non-medical personnel were aware of the term pharmacovigilance. Purpose of pharmacovigilance was known to only 13 % of paramedics and 3 % for non-medical personnel. 45% paramedics and 69% non-medical participants were not aware of suspected ADR reporting system in India showing very limited knowledge among the participants. A positive attitude has been observed among the participants as over 65% of participants from both the groups have chosen for establishing of ADR monitoring centre in every hospital with approximately 56% from both groups thinks that reporting of adverse drug reaction is necessary. Practice part seems to be the area of concern as active participation is lacking among the participants of both groups. Only 2% of paramedics have ever played a role in reporting of ADR followed by 1% from non-medical personnel group. Conclusion: Our research study had revealed that paramedics in comparison to non medical personnel have better knowledge, both the groups have considerable attitude towards pharmacovigilance which shows positivity towards future prospects. Practice part seemed to be poor in both groups however participant’s willingness to participate in ADR monitoring was appreciable. Sharing the knowledge and uplifting the practice based performance by active self participation could bring promising results in solving problems related to ADR underreporting.
Prevalence Of Anxiety Disorder In Patients With Substance Use Disorder In Southern Rajasthan
Objective: This study aims to investigate the prevalence of anxiety disorders among patients diagnosed with substance use disorder (SUD). Given the high comorbidity of mental health conditions in SUD populations, understanding the extent of anxiety disorders is crucial for developing comprehensive treatment strategies. Methods: A cross-sectional study was conducted with 100 patients diagnosed with substance use disorder attending Psychiatry Department of American International Institute Of Medical Sciences Udaipur, Rajasthan. Data were collected using the Generalized Anxiety Disorder-7 (GAD-7) scale for assessing anxiety severity. Sociodemographic information, such as age, gender, type of substance used, and duration of substance use, was also recorded. Inclusion criteria Patients who have given written informed consent. Patients of any gender, aged 18 years or old diagnosed with substance use disorder. Exclusion criteria Patients with known psychiatric comorbidity. Patients having organic anxiety disorder. Results: Among the 100 participants, 70% exhibited symptoms of anxiety. Of these, 35% had moderate anxiety, 20% had severe anxiety, and 15% reported mild anxiety symptoms. The remaining 30% showed no significant anxiety symptoms. A significant association was found between the severity of anxiety and the duration of substance use (p<0.05), with longer histories of use correlating with higher anxiety severity. Alcohol and opioid users had the highest prevalence of anxiety disorders. Conclusion: The study demonstrates a high prevalence of anxiety among patients with substance use disorder. The findings suggest that anxiety should be routinely assessed in this population, and integrated treatment approaches addressing both substance use and anxiety are essential for improving overall patient outcomes.
Effect of Daipramatic Breathing and Systamatic Relaxation in Depression
Depression is a prevalent and complex mental health disorder affecting millions globally, often leading to persistent sadness, fatigue, cognitive impairments, and social withdrawal. While pharmacological and psychotherapeutic interventions are widely used, complementary approaches like yogic practices are gaining recognition for their holistic benefits. This study explores the therapeutic effects of diaphragmatic breathing and systematic relaxation techniques on individuals experiencing depressive symptoms. Diaphragmatic breathing, a deep abdominal breathing practice, activates the parasympathetic nervous system, thereby reducing cortisol levels, promoting emotional regulation, and restoring physiological balance. When performed regularly, it improves oxygen-carbon dioxide exchange, enhances vagal tone, and helps alleviate stress, anxiety, and mood disturbances. Systematic relaxation, including practices such as Shavasana, tension-relaxation techniques, Yoga Nidra, and mindfulness meditation, further supports the mind-body connection, reduces muscle tension, stabilizes heart rate and blood pressure, and promotes deep rest and mental clarity. This paper reviews the physiological mechanisms, anatomical correlations, and psychological benefits of these techniques, drawing from yogic philosophy and modern research. These non-invasive, low-cost practices can serve as effective adjuncts in a broader therapeutic model for depression management. While not substitutes for clinical treatment, they offer a sustainable path toward emotional resilience, better sleep, improved mood, and enhanced quality of life. Overall, integrating diaphragmatic breathing and systematic relaxation into daily routines can empower individuals to take an active role in their mental well-being, supporting both preventive and rehabilitative mental health strategies.
A Quality Improvement Project on Prevention of Falls in Himalayan Hospital, Dehradun
Falls that occur in hospitalized patients are a widespread and serious threat to patient safety. Accidental falls are among the most common incidents reported in hospitals, complicating approximately 2% of hospital stays. These incidents can lead to injuries, prolonged hospitalization, increased healthcare costs, and a decline in patient confidence and quality of life. To address this critical issue, a quality improvement project focusing on patient fall prevention was undertaken with the primary goal of enhancing practices related to fall prevention and reducing the incidence of falls in the hospital setting. The project began with a comprehensive analysis of fall incidents reported between January and July 2019. Root cause analysis revealed multiple contributing factors including inadequate staff training, inconsistent fall risk assessments, and lack of adherence to safety protocols. Based on these findings, a set of targeted interventions were developed and implemented. These included staff training sessions, the introduction of updated fall prevention policies and guidelines, reinforcement of safety practices, and continuous monitoring and auditing of compliance. As a result of these concerted efforts, a significant reduction in fall incidents was observed. By the end of 2020, the number of reported falls had decreased by 45% compared to previous levels. Notably, the incidence of falls remained below 0.2 per 1000 inpatient days from July 2019 onwards. Furthermore, improvements were noted in the regular assessment and reassessment of fall risk, as well as in the implementation of individualized preventive strategies. These outcomes highlight the effectiveness of a structured, data-driven approach to patient safety improvement.
A Review of Pharmacovigilance Aggregate Reporting: Recent Trends
Pharmacovigilance aggregate reporting plays a pivotal role in monitoring drug safety and supporting regulatory decision-making. This review examines recent trends in aggregate reporting, focusing on evolving methodologies, innovative technologies, and their applications in detecting and managing drug-related risks. Advancements such as data mining algorithms, artificial intelligence, and real-world data integration have transformed the field, enabling more efficient and accurate safety assessments. The review also highlights key regulatory guidelines and requirements at international and regional levels, offering insights into their impact on reporting practices. Challenges faced by stakeholders, including data quality, system interoperability, and resource limitations, are analyzed to provide a comprehensive understanding of existing barriers. Additionally, case studies and success stories demonstrate the positive influence of aggregate reporting on public health outcomes. The review concludes with actionable recommendations for improving pharmacovigilance systems and identifies critical areas for future research to enhance global drug safety surveillance.
Trauma and Violence Informed Practices in Victim Services: A Comparative Review
Trauma and Violence Informed Practices (TVIP) mark a critical shift in the delivery of victim services by acknowledging not only the psychological impact of interpersonal violence but also the structural and systemic conditions that perpetuate harm. Positioned within a victimological framework, this paper explores the evolution of TVIP from its clinical and community-based roots to its institutional applications across justice, health, and social care systems. Through a comparative examination of Canada, the United States, and Australia, the study identifies key strategies such as inter-agency collaboration, culturally responsive service design, and survivor-led engagement that have enabled the integration of TVIP principles into diverse legal and social infrastructures. The analysis demonstrates how these countries have begun embedding trauma awareness into routine operations, despite the challenges in standardization, accessibility, and sustainability. Drawing from these insights, the paper critically examines the Indian context, where services for survivors of gender-based violence and legal mechanisms exist but often lack trauma-informed orientation. The paper argues that localizing TVIP in India requires both systemic reform and cultural adaptation, particularly in how police, judiciary, and support services engage with women and children experiencing domestic violence, sexual assault, and child abuse. Ultimately, the paper positions TVIP as a foundational approach to survivor-centered justice, one that transcends procedural assistance to affirm dignity, safety, and empowerment as core institutional values. By foregrounding the lived experiences of survivors, the study advocates for the urgent integration of TVIP within India's evolving victim assistance ecosystem.
Comparative Study To Determine Role Of ASHA Workers In Reduction Of Anxiety And Increasing Utilization Of Antenatal Services Among Pregnant Women
Introduction: This cross-sectional comparative study aims to investigate the impact of Accredited Social Health Activists (ASHA) on stress levels and Antenatal Care (ANC) service utilization among pregnant women in a rural village of Maharashtra. With a focus on enhancing maternal healthcare, ASHA workers' influence on ANC services and anxiety levels is explored. Methodology: Conducted over 60 days in May-June 2023, the study involves 130 pregnant mothers, divided into two groups: those supported by ASHA workers (Group A) and those accessing healthcare facilities directly (Group B). A pretested questionnaire and the State-Trait Anxiety Inventory (STAI) assess socio-demographics, ANC service utilization, and anxiety levels among participants. Results: Statistical analyses reveal significant associations between ASHA engagement and increased ANC service utilization among pregnant women. While stress levels did not show statistical significance, a trend towards lower stress among ASHA-supported individuals is observed. Conclusion: The findings emphasize the pivotal role of ASHA workers in enhancing ANC service utilization among pregnant women. Although stress levels did not yield significant differences, the trend highlights potential benefits of ASHA support. Further research with larger samples and refined methodologies is advocated to deepen understanding in this domain.
Hyperbaric Oxygen Therapy: A Comprehensive Literature Review Of Mechanisms, Clinical Indications, And Emerging Applications
Hyperbaric oxygen therapy (HBOT) delivers 100% oxygen at pressures above atmospheric level to enhance tissue oxygenation. It has established efficacy in specific conditions such as decompression sickness, carbon monoxide poisoning, and radiation-induced tissue injury. Increasing evidence suggests its potential benefits in neurological injuries and chronic wounds. This review summarises the physiological basis of HBOT, approved indications, emerging clinical uses, safety considerations and current challenges, providing an updated synthesis for clinicians and researchers involved in hyperbaric medicine.
Development of Cognitive Retraining Module for Cancer and Alzheimer’s Patient
Introduction: The risk for non-communicable disorders (NCD) are increasing among adults. The prevalence rate of non-communicable diseases is high in India. These patients often suffer from cognitive decline along with physical and psychological issues during the illness. To manage cognitive dysfunction among chronic illness, Cognitive Retraining Therapy (CRT) have been emphasized by the professionals. Aim and Methodology: The present study aims to develop cognitive retraining module for patients with cancer and Alzheimer’s disease (AD). Several search engines were used for the identification of the literature. Original studies, research articles, randomized controlled trials done in last 20 years were selected for the review. PRISMA guidelines were used and related literature was analyzed by the reviewer and included in the data synthesis. Based on the review, module was developed and further validated by the experts in the field of neuropsychology, psycho-oncology, clinical psychology and geriatric psychology. Summary of Results: Current cognitive retraining module focused on attention, executive and memory function of cancer and Alzheimer patients. About seventy activities based on the above domains were included in the module. Each activity took 15-20 minutes, graded level of difficulty, paper-pencil mode with emphasis on verbal and visual modality. Implications: Cognitive retraining module is non-pharmacological, manualized and culturally appropriated intervention for patients with cancer and Alzheimer’s disease.
The Study Of Psychosocial Stress Including Quality Of Life In Care Givers Of Patients Of Dementia
Introduction: The number of patients with dementia worldwide is estimated to be approximately 55 million, with nearly 10 million new cases reported each year. The concept of quality of life has received great attention from healthcare providers and health administration, due to the underlined importance of evaluating or determining the general health status of individuals suffering from chronic illness. Dementia is a chronic disorder of the brain that affects cognitive performance. The caregivers of individuals with dementia experience a greater burden that affects their Quality of Life (QoL). Aim and Objective: The study of psychosocial stress including quality of life in care givers of patients of dementia Material and Methods: This was a Hospital based out Patient Department (OPD) study carried out in the Department of Geriatric for a period of 12 months i.e, February 2023 to Febsuary 2024 where index cases were the consecutive cases of dementia, attending to Psychiatry OPD at a tertiary care centre. Caregivers (Key and Other) of patients of Dementia were identified. These caregivers were assessed and compared for psychosocial stress and quality of life amongst them due to care giving. The diagnosis of dementia was made by one of the supervisors on the basis of ICD-10 DCR. Results: In the present study most of the key caregivers (40%) reported some stress and strain followed by moderate stress (36%) and severe stress (12%) in care giving. Similar was pattern of reporting by other care givers. Most of the key care givers (40%) reported feeling mild depressive mood followed by non significant depressive mood (32%). The gold standard interview revealed that majority of the key care givers (52%) suffered with depression followed by sub syndromal mental health problem (20%) and mixed anxiety depression (16%). Eight percent patient of the key care givers were found to be suffering with anxiety disorders. Amongs to ther care givers,majority(61.8%)reported having no psychiatric morbidity followed by depressive disorder (20.6%) and sub-syndromal mental health problems (11.8%). It was also observed that amongst the caregivers who were diagnosed to be suffering with depression, majority of the key caregivers (53.8%) and other care givers (71.4%) had mild level of depression. Most of the key caregivers (64%) reported severe level of burden followed by moderate burden (36%). All the key care givers reported experiencing burden in care giving. On the other hand the majority of other care givers (85.4%) reported experiencing moderate burden followed by sever burden (8.8%) and no burden (5.8%) on Burden Assessment Schedule. Conclusion: Anxiety and depression are the most common affective neuropsychiatric symptoms of dementia of individuals. Therefore, caregiver subjective health is an important factor to consider in order to reduce caregiver burden. The result of the present study provides a broad picture of the need to support and educate both families and caregivers of the elderly with dementia in the community.
Virtual Reality's Efficacy In Assessing And Treating Phobias And PTSD: A Literature Review
The study sought to determine the role of virtual reality in the assessment and treatment of phobias and post-traumatic stress disorder. The study employed the literature review method and reviewed 20 published articles for the study. These were studies that were based on primary research only. The study explored five specific types of phobia, which are small animal phobia, arachnophobia, acrophobia, fear of public speaking, and dental phobia. The study revealed that virtual reality provides an effective way of assessing and treating phobias and post-traumatic stress disorder (PTSD), especially where 360-degree videos and pictures are included. It provides an immersive method that allows the patients to face their fears rather than avoid them. It also offers a method that reduces avoidance behavior in patients compared to other treatment approaches. Advances in technology have resulted in the adoption of VR through the use of smartphones, and this could provide a great way for more widespread adoption of VR in treatments. There is still a need to improve the efficacy of VR by addressing its current limitations.
Clinicoradiological Sarcoidosis: A Case Study Of Extensive Mediastinal And Abdominal Nodal Calcifications With Pulmonary Nodularity
Aim: To present a rare case of sarcoidosis with extensive calcifications in mediastinal and abdominal lymph nodes, accompanied by perilymphatic pulmonary nodules, emphasizing the diagnostic value of radiological imaging in such atypical presentations. Introduction: Sarcoidosis is a multisystem granulomatous disorder of unknown cause, predominantly affecting the lungs and lymphatic system. While typical imaging findings can guide diagnosis, atypical radiological features require careful evaluation to differentiate from malignancy or other conditions. Materials and Methods: A 58-year-old female reported persistent cough and breathlessness. High-resolution computed tomography (HRCT) of the chest and contrast-enhanced CT (CECT) of the abdomen were performed. Imaging revealed multiple calcified lymph nodes across mediastinal and abdominal compartments. Pulmonary nodules were observed along peribronchovascular and subpleural regions, predominantly in a perilymphatic distribution. Additional findings included the nodular interface sign and axial interstitial thickening. Whole-body PET-CT and clinical investigations were undertaken to rule out malignancy. Results: Radiological evaluation showed extensive lymph node calcifications in the paraesophageal, pretracheal, paratracheal, subcarinal, and prevascular regions of the mediastinum, as well as abdominal nodes including celiac, peripancreatic, porta hepatis, precaval, and paraaortic areas. Lung imaging demonstrated peribronchovascular thickening, subpleural nodules, and nodular interfaces—hallmark features suggestive of sarcoidosis. PET-CT findings further supported a benign, inflammatory etiology. The diagnosis of sarcoidosis was established through clinicoradiological correlation. Conclusion: This case underscores the critical role of imaging in diagnosing atypical sarcoidosis. The presence of widespread nodal calcification and classic perilymphatic pulmonary nodules should prompt consideration of sarcoidosis, particularly when malignancy is excluded. Radiological assessment, combined with clinical evaluation, is vital for accurate diagnosis and appropriate management of unusual presentations of sarcoidosis.
Impact Of Education On Addenbrooke's Score (ACE-III) In Type 2 Diabetes: A Cross Sectional Study In Kanpur, North India
Background and aim: There have been few studies from South Asia which have shown increased prevalence of cognitive impairment (CI) in diabetes and few of European and Indian studies had shown positive impact of education on Addenbrooke's Cognitive Examination-III (ACE-III) Score. The present study was designed to evaluate the impairment in cognition by using Addenbrooke's Cognitive Examination-III test and assess impact of education on ACE-III Score. Materials and methods: We assessed cognitive function in 54 type 2 diabetes participants using Addenbrooke's Cognitive Examination-III (ACE-III) test. Results: The mean age and HbA1c of cases was 64.5 ± 5.3 years and 8.8 ± 2.5%, respectively. The illiterate diabetic participants had more CI with compared to literate diabetic participants but there was no difference among non diabetic group. Conclusion: Diabetes may cause CI and is related to poor self-care. Considering a high prevalence of CI in diabetes, cognitive assessment should be a part of overall evaluation. ACE-III is a sensitive and convenient tool for this purpose.
Rapid Screening Tool for Addiction by Caregivers- A Novel Approach
Addiction is a major public health crisis that affects millions globally, leading to severe physical, psychological, and social consequences. Substance use disorders (SUDs), including alcohol, tobacco, and illicit drug addiction, as well as behavioral addictions such as gambling and internet addiction, often remain undetected until they cause significant harm. Early identification is crucial for timely intervention and treatment, yet many cases go unnoticed due to stigma, denial, or lack of awareness (Volkow et al., 2016).
The Role of Gut Bacteria in Affecting Brain Health and Its Relationship with Neurological Diseases
Background: The gut-brain axis represents a bidirectional communication network between the gastrointestinal system and the central nervous system, with gut microbiota playing a pivotal role in influencing brain health. Emerging evidence links gut dysbiosis to neurological disorders such as Parkinson’s disease, Alzheimer’s disease, and major depressive disorder. This study aimed to investigate the relationship between gut microbiota composition and neurological health by comparing individuals with neurological diseases to healthy controls. Methods: A quantitative, observational, case-control design was employed, involving 200 participants (100 with neurological disorders and 100 healthy controls). Fecal samples were collected, and microbial DNA was sequenced using the Illumina MiSeq platform targeting the V3-V4 regions of the 16S rRNA gene. Microbial diversity and composition were analyzed using bioinformatics tools (QIIME2, SILVA database). Sociodemographic, lifestyle, and clinical data were collected via questionnaires and medical records. Statistical analyses included t-tests, chi-square tests, and multivariable regression. Results: The neurological group showed significantly lower levels of beneficial bacteria (Bacteroides: 41% vs. 78%; Lactobacillus: 38% vs. 66%) and higher levels of potentially harmful genera (Clostridium: 71% vs. 40%; Escherichia: 64% vs. 33%) compared to controls. Neuropsychiatric symptoms were prevalent, with 35% exhibiting severe cognitive impairment and 44% severe mood disturbances. Lifestyle factors like sedentary behavior (62% vs. 36%) and high sugar intake (66% vs. 40%) were more common in the neurological group. Conclusion: The study confirms a distinct gut microbiota profile in individuals with neurological diseases, supporting the role of gut dysbiosis in neurological dysfunction. These findings highlight the potential for microbiota-targeted interventions (e.g., probiotics, dietary modifications) as therapeutic strategies. Further research is needed to establish causal mechanisms and develop personalized approaches for improving brain health through gut microbiota modulation.
Bacteriophage Therapy As An Alternative To Antibiotics: A Meta-Analysis
Background: The rise of antimicrobial resistance has driven the search for alternative therapies. Bacteriophage (phage) therapy, which employs viruses to target specific bacterial pathogens, is regaining attention as a promising solution for multidrug-resistant (MDR) infections. Objective: This meta-analysis aims to evaluate the clinical efficacy, safety, and treatment outcomes associated with phage therapy in managing MDR bacterial infections. Methods: A systematic review and meta-analysis were conducted using data from observational studies and case reports published between 2000 and early 2025. Eligible studies included human subjects treated with phage therapy for laboratory-confirmed MDR infections. Data were extracted on clinical outcomes, adverse events, phage characteristics, and concurrent antibiotic use. Risk of bias was assessed using the ROBINS-I tool for observational studies and the Joanna Briggs Institute (JBI) checklist for case reports. A random-effects model was used to calculate pooled cure rates and assess heterogeneity. Results: Eight studies involving 196 patients were included in the meta-analysis. The pooled clinical cure rate was 71% (95% CI: 0.59–0.81), with moderate heterogeneity (I² = 44.4%). The highest efficacy was observed in studies targeting complex infections like prosthetic joint infections and osteomyelitis. Adverse events were rare and generally mild. Case reports also showed a favorable safety profile and microbiological clearance in 8 out of 9 patients. Conclusion: Bacteriophage therapy demonstrates substantial clinical promise as an adjunct or alternative to antibiotics for MDR infections. Despite limitations related to study design and heterogeneity, these findings support the integration of phage therapy into clinical practice and highlight the need for standardized protocols and randomized controlled trials.
Innovative Approaches in Thyroid Cancer Surgery: A Comparative Study of Total vs. Partial Thyroidectomy; Systematic Review
Background: Thyroid cancer, predominantly papillary thyroid carcinoma (PTC), has seen a rising global incidence due to advancements in diagnostic techniques. Total thyroidectomy (TT) and partial thyroidectomy (PT), especially lobectomy, are the primary surgical treatments. Recent innovations, including robotic and endoscopic techniques, have reshaped the surgical landscape. Objective: This systematic review evaluates and compares TT and PT in the management of intermediate-risk PTC, emphasizing surgical outcomes, complications, recurrence, and the role of innovative approaches. Methods: A comprehensive search of PubMed, Embase, and Cochrane Library databases identified comparative studies up to April 2025. Eight retrospective cohort studies involving 2,984 patients were included. Key outcomes assessed were recurrence rates, surgical complications, and postoperative recovery metrics. Data were synthesized using RevMan 5.4 with subgroup and sensitivity analyses. Results: Recurrence rates were similar between TT and PT groups. PT demonstrated fewer overall complications, particularly transient hypocalcemia and recurrent laryngeal nerve palsy. Cosmetic satisfaction and recovery metrics favored PT. No significant difference was found in permanent complications or recurrence. The inclusion of minimally invasive and robotic techniques was associated with enhanced cosmetic and functional outcomes. Conclusions: Partial thyroidectomy offers comparable oncologic control to total thyroidectomy in appropriately selected patients with intermediate-risk PTC, with the added benefit of fewer complications and better postoperative quality of life. Ongoing innovation in surgical techniques further supports the shift toward conservative management when clinically appropriate.
Cardiovascular Complications in Patients With Hypertension: A Retrospective Study
Background: Hypertension is a leading global contributor to cardiovascular morbidity and mortality, with complications often resulting in stroke, myocardial infarction, and heart failure. This study assesses the prevalence and predictors of cardiovascular events among hypertensive patients over a five-year period. Methods: A retrospective cohort study was conducted on 500 adult hypertensive patients from 2018 to 2023. Patients with prior cardiovascular disease were excluded. Data were extracted from electronic medical records, including demographics, comorbidities, smoking history, BMI, and cardiovascular complications. Statistical analyses involved chi-square tests and logistic regression to identify significant predictors of events. Results: Cardiovascular complications occurred in 196 patients (39.2%), with stroke (18.4%) as the most common outcome, followed by heart failure (15.2%) and myocardial infarction (12.2%). Age ≥65 years (OR = 2.31; 95% CI: 1.51–3.54) and diabetes mellitus (OR = 2.84; 95% CI: 1.91–4.21) were strong independent predictors. Male sex modestly increased risk (OR = 1.62; p = .041). Smoking and obesity showed non-significant trends toward increased complications. Subgroup analysis indicated diabetic hypertensives were more prone to stroke and heart failure. Conclusion: A substantial proportion of hypertensive patients develop cardiovascular complications, particularly those who are older or diabetic. Targeted interventions focusing on age and metabolic risk modification are critical to reducing disease burden in this population.
Psychiatric Comorbidities and Familial Genetics in Children and Adolescents with Dissociative (Conversion) Disorder: A Cross-Sectional Study from Western Rajasthan.
Background: Dissociative (conversion) disorder (DCD) is a complex psychiatric condition characterized by disruptions in consciousness, identity, memory, or perception. It is commonly seen in children and adolescents in clinical settings, often accompanied by psychiatric comorbidities and influenced by familial psychiatric history. This study aimed to assess psychiatric comorbidities and genetic predispositions among pediatric DCD patients in Western Rajasthan. Methods: A cross-sectional study was conducted on 80 children and adolescents (ages 6–18) diagnosed with DCD at a tertiary care hospital in Jodhpur, Rajasthan, from July 2021 to July 2022. Psychiatric comorbidities were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (K-SADS-PL). Family psychiatric history was evaluated through the Family Interview for Genetic Studies (FIGS). Statistical analyses included chi-square and Spearman correlation tests using SPSS-23. Results: The mean age was 14.21 years; 82.5% were female. Most belonged to lower socioeconomic status and nuclear families. Convulsion-type DCD was the most common presentation (48.8%). Psychiatric comorbidities were found in 71.2% of participants, with anxiety disorders (25%) being the most prevalent, followed by somatoform (18.8%) and depressive disorders (17.5%). A positive family history of psychiatric illness was found in 58.8% of patients, most commonly anxiety disorders (10%) and DCD (8.8%). A statistically significant association was found between psychiatric comorbidities and positive family psychiatric history (χ² = 18.246, p < 0.001). Conclusions: DCD in children and adolescents is frequently associated with psychiatric comorbidities and a family history of mental illness, suggesting both environmental and potential genetic contributions. Early identification and integrated family-based interventions are critical to improving outcomes.
Financial Planning And Decision-Making And Its Gender Role Among Ethnic Households In Kerala
Financial planning and decision-making at household level determines the better financial performance and it determines the household savings and investment. The proper planning and decision-making at household level is important to reduce various types of financial difficulties. Since independence, the government provided numerous types of financial assistance to the tribes and the important reason for their financial backwardness is also attached to the absence of proper financial planning and decision-making at their individual and household level. This paper is an attempt to examine the prevalence of financial planning and decision-making among prominent tribal households in Wayanad district of Kerala. Besides overall evaluation, the concept was analyzed and compared across the five sample tribal groups, namely the Paniya, the Adiya, Kattunaika, Kurichiya and Kuruma households. The study observed significant difference in the degree and dimension of practicing the financial planning and decision-making among the study groups and also a greater male dominance in the financial matters among the tribal households.
Developing an Implementation Framework for the Education of Deafblind Learners in Malaysia: A Strategic Review of International Policy Comparisons
This article presents a comparative document analysis of educational policies and implementation frameworks for deafblind learners in Malaysia, the United States, and Sweden. While the US and Sweden have established comprehensive legal recognition, specialised service delivery, teacher training, and inter-agency collaboration, Malaysia lacks a clear policy definition and systemic support for this group. The study highlights critical gaps in Malaysia’s policy and practice, underscoring the need for legal reform, targeted teacher preparation, integrated service models, and effective data monitoring. The findings offer evidence-based recommendations to advance inclusive education for deafblind learners in Malaysia, aligning with international mandates such as the UN Convention on the Rights of Persons with Disabilities (UNCRPD).
A Study to Assess the Association of Duration of Smartphone Use with Sleep Quality and Cognitive Functioning in Undergraduate Medical Students
Purpose: This cross-sectional study investigated the prevalence and effects of smartphone usage patterns on sleep quality and cognitive functioning among undergraduate medical students. Methods: We conducted our study on 200 students selected through stratified random sampling at Atal Bihari Vajpayee Government Medical College, Vidisha. Data were collected using standardized instruments including the Pittsburgh Sleep Quality Index (PSQI), Montreal Cognitive Assessment (MoCA), and Mobile-Related Sleep Risk Factors (MRSRF) questionnaire. Statistical analysis was performed using SPSS v16.0, with p<0.05 considered significant. Results: The average screen usage time was 5-6 hours daily, with 26.5% of participants reporting >7-8 hours of daily use. The mean PSQI score was 5.74±2.13, with 79% of students experiencing mild sleep difficulty. The mean MoCA score was 26.81±1.72, with 20.5% showing mild cognitive impairment. Despite high prevalence of both smartphone use and sleep/cognitive issues, no statistically significant association was found between screen time and sleep quality (p=0.99) or cognitive function (p=0.872). Conclusions: While a substantial proportion of medical students experience mild sleep difficulties and cognitive impairment, our findings suggest that smartphone usage patterns may not be directly responsible for these issues. Nevertheless, education on mindful smartphone use remains important for maintaining overall wellbeing and academic performance.
Methicillin Resistant Staphylococcus Aureus (MRSA) – A Study On Its Prevalence And Antimicrobial Susceptibility Patterns In A Tertiary Teaching Hospital Of Rural West Bengal
INTRODUCTION- Methicillin resistant Staphylococcus aureus (MRSA) is endemic in India with more than 50% of S. aureus infections being caused by methicillin-resistant strains of Staphylococcus aureus which poses a high therapeutic challenge. Healthcare workers are the main source of transmission of MRSA among hospital admitted patients. MRSA is resistant to several classes of antibiotics including some recent resistance also being observed towards glycopeptides as well as aminoglycosides making the treatment of infections and their eradication very difficult. AIMS- To identify MRSA strains from different clinical samples of hospital patients and to study their clinic-demographic profile and antibiotic susceptibility pattern. MATERIALS AND METHODS- This study was conducted at the Department of Microbiology of Tamralipto Government Medical College and Hospital from May 2024 to April 2025 on 1385 clinical samples received from various departments and were subjected to automated ID and AST by VITEK2 compact (Biomerieux) and Methicillin resistance was detected by using Cefoxitin susceptibility as a surrogate marker by VITEK2 compact method. RESULTS- Out of 1385 clinical samples received at our laboratory, 488 MRSA samples were isolated (35.23%). MRSA was highest in pus sample (36.07%) and lowest in respiratory samples. Most of the MRSA isolates were from Medicine department (37.91%) followed by ICU (19.06%) least from chest medicine department (3.07%). Among all the 488 MRSA patients, highest number was observed in the younger age group 21-40 years and least patients were in the elderly age >60 years. MRSA isolates showed maximum sensitivity towards Glycopeptides and Linezolid and least sensitivity towards Norfloxacin and Macrolides. CONCLUSION- Regular surveillance of antimicrobial susceptibility pattern of MRSA infections for the formulation of antibiotic policies and proper infection control practices will help to reduce the burden of MRSA infections in hospitals.
Exploring The Scope And Challenges Of Telehealth Integration In Indian Nursing Practice: A Critical Review
The integration of telehealth in Indian nursing practice is gaining momentum, especially post-COVID-19, to improve healthcare accessibility and quality. This review critically examines the scope of telehealth within Indian nursing, highlighting the challenges nurses face, including infrastructural limitations, digital literacy gaps, cultural diversity, and regulatory concerns. It further discusses educational shortcomings and ethical considerations inherent to virtual healthcare. By analyzing global telehealth frameworks and aligning them with India’s healthcare context, this paper proposes strategic recommendations to enhance nursing preparedness and telehealth sustainability.
Integrating Family Medicine into Preventive Healthcare for Improved Patient Well-being: Cross-Sectional Study
Background: Preventive healthcare plays a crucial role in reducing disease burden and improving overall well-being. Family medicine, with its holistic and patient-centered approach, is well-positioned to integrate preventive services into routine care. However, various barriers limit the effectiveness of preventive care in family medicine settings. This study aimed to assess the extent of preventive healthcare integration within family medicine and identify the factors influencing its utilization. Methods: A cross-sectional study was conducted among 200 patients and 50 family physicians in primary healthcare centers and family medicine clinics. Data were collected through structured questionnaires assessing preventive healthcare utilization, barriers, and physician involvement. Additionally, medical record reviews were conducted to validate preventive care practices. Descriptive and inferential statistical analyses were performed using SPSS to evaluate patient engagement, physician practices, and institutional support for preventive healthcare. Results: The findings revealed that 62.5% of patients underwent annual check-ups, while 80.0% had blood pressure screenings, and 75.0% had blood glucose screenings. However, cancer screening rates were lower at 45.0%, and only 55.0% of patients were up to date on vaccinations. Key barriers to preventive healthcare included lack of awareness (40.0%), time constraints (35.0%), and cost of services (30.0%). Among physicians, 80.0% routinely discussed preventive care, but 60.0% cited time constraints as a significant challenge. Patient satisfaction with family medicine services was high, with 82.5% of participants reporting satisfaction or high satisfaction with the care they received. Conclusion: The study highlights the positive role of family medicine in delivering preventive healthcare, but gaps remain in cancer screening and vaccination coverage. Barriers such as lack of awareness, financial limitations, and physician workload affect preventive care accessibility. Strengthening institutional support, improving patient education, and adopting innovative solutions to ease physician burden are essential for optimizing preventive healthcare delivery. Addressing these challenges can lead to a more proactive healthcare model that enhances patient well-being and reduces long-term disease burden.
Prevalence of Cognitive Impairment in Patients with Chronic Migraine: A Cross-Sectional Study
Background: Cognitive impairment is increasingly recognized as a comorbid feature of chronic migraine (CM), affecting various cognitive domains such as attention, memory, and executive function. However, its prevalence and contributing factors remain unclear. This study aimed to assess cognitive impairment in CM patients compared to those with low-frequency episodic migraine (EM) and investigate potential associations with clinical and psychological variables. Methods: A cross-sectional study was conducted involving 120 CM patients and 40 age-matched EM patients. Participants underwent standardized cognitive assessments, including the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Perceived Deficits Questionnaire (PDQ-20), and Rey Auditory Verbal Learning Test (RAVLT). Depression and anxiety levels were evaluated using the Hospital Anxiety and Depression Scale (HADS). Statistical analyses were performed to compare cognitive performance between groups and identify correlations between cognitive impairment, clinical characteristics, and psychological factors. Results: CM patients exhibited significantly lower cognitive scores across all measures compared to EM patients (p < 0.001). MoCA and DSST results indicated deficits in executive function, attention, and processing speed, while RAVLT and PDQ-20 scores revealed impairments in memory and subjective cognitive complaints. Cognitive dysfunction was negatively correlated with headache frequency, depression, and anxiety scores (p < 0.001). Regression analysis identified headache frequency and chronic pain duration as independent predictors of cognitive impairment, whereas depression and anxiety were not significant contributors. Conclusion: Cognitive impairment is prevalent in CM patients, affecting multiple domains and persisting even in pain-free intervals. Chronic pain and headache frequency appear to be primary contributors to cognitive decline rather than psychiatric comorbidities. These findings highlight the need for early migraine management strategies to prevent long-term cognitive deterioration. Future studies should explore longitudinal changes and potential interventions to mitigate cognitive decline in CM patients.
Isolation And Identification Of Fungi Causing Dermatophytosis
INTRODUCTION: Dermatophytes are the most important fungi affecting the skin due to their extensive impact on people across the globe and their high prevalence in the general population.1 This study aims to isolate and identify the dermatophytes and to compare the clinical diagnosis with potassium-hydroxide smear positivity and culture positivity. MATERIALS & METHODS: 75 clinically suspected patients of dermatophytosis who attended the Department of Dermatology were included in the study after giving informed consent. The specimen is mounted in KOH (10% for skin scrapings and hair, 20-40% for nail clippings) and was examined for the presence of thin, septate, and hyaline hyphae. The samples were inoculated on SDA slants containing 0.05% chloramphenicol, 0.1% gentamicin, and 0.5% Cycloheximide and dermatophyte test medium(DTM). RESULTS: The samples were collected from a wide range of age group falling in the range of 6-78 years. Most common age group affected was found to be 31-40 years. 22.85% cases of Tinea corporis were seen in the age group of 21-30 years. Tinea cruris was more common in the age group 21-30 and 31-40 years each with 4 cases(23.52%). 50% of children were affected with Tinea capitis . CONCLUSION: The infection predominantly affects individuals between 31-40 years of age, with a higher incidence in males, especially those engaged in manual labor or household work. Laboratory identification through microscopy and culture confirms that T. rubrum is the most common species involved, followed by T. mentagrophytes and T. tonsurans. This highlights the need for targeted preventive measures and effective treatment strategies in these high-risk groups.
The Concept Of Maintaining Peace And Order Situation In The Mystique Island Of Siquijor, Philippines: An Advocacy For The Sustenance Of Peace
This qualitative study investigated the concept of maintaining peace and order in Siquijor, Philippines, employing a descriptive-qualitative survey design incorporating observations and one-on-one interviews with 150 Barangay Officials and 300 residents. A combined purposive and stratified sampling technique ensured representation across various demographics and key stakeholders. Data analysis involved meticulous data pre-processing, descriptive and inferential statistics, and qualitative analysis techniques tailored to each sampling method. The findings, presented as percentages and emergent themes, provide insights into community perceptions of peace and order, highlighting both strengths and challenges. This mixed-methods approach offers a rich understanding of the complex interplay between environmental sustainability, human rights, governance, electoral integrity, and tourism in shaping the peace and order situation in Siquijor. The study contributes valuable data for developing targeted, culturally sensitive peacebuilding strategies. -HVDD
Impact of Statin Intolerance on Functional Capacity and Quality of Life in Patients with Cardiovascular Comorbidities
Background: Long-term statin therapy is essential in managing cardiovascular risk but may lead to muscle-related adverse effects, contributing to functional limitations and diminished quality of life. This study explores the functional impact of statin intolerance among patients with cardiovascular comorbidities. Objective: To assess the effect of statin intolerance-associated muscle symptoms on physical functioning and perceived quality of life in patients on long-term statin therapy. Methods: An observational cross-sectional study was conducted among 110 patients aged 30 to 80 years on statins for at least one year. Data on muscle-related symptoms, occupation type, functional limitations, and biochemical markers were collected. Functional limitation was inferred from the site and severity of muscle pain, physical performance status, and change in activity patterns. Results: Among 110 patients, 56 (51%) reported muscle-related complaints. Of these, 55 (98.2%) experienced pain in the hip flexors, thighs, or calves, and 43 (76.7%) had pain in the shoulders or proximal upper limbs. Pain was more common during movement (61.8%) than palpation (20%). Patients reporting pain had significantly greater physical limitation, especially in moderate and heavy occupation categories. Pain symptoms were exacerbated by exertion in 48% of cases. Elevated CK levels were found in 24.5% of symptomatic patients. Approximately 68% of symptomatic patients reported reduced mobility, 43% had difficulty performing household chores, and 21% had partially withdrawn from previously routine activities. Nearly 18% of affected individuals reported symptoms of low mood, anxiety, or social withdrawal secondary to physical limitation. Conclusion: Statin intolerance, particularly muscle-related symptoms, significantly impairs functional capacity and may adversely affect quality of life in patients with cardiovascular comorbidities. Clinical recognition and individualized statin management may help preserve function and enhance patient wellbeing.
"Dynamic Hip Screw Vs. Locking Compression Plate: A Surgical Approach To Intertrochanteric Fractures"
Background: The Dynamic Hip Screw (DHS) is widely regarded as the standard treatment for intertrochanteric fractures. Nonetheless, some orthopedic surgeons opt for alternative fixation devices such as the Locking Compression Plate (LCP). Objectives: This study aimed to compare the clinical outcomes of DHS versus LCP in the surgical treatment of intertrochanteric femoral fractures. Materials and Methods: In this cross-sectional study, 124 patients presenting with intertrochanteric fractures were treated using either DHS or LCP devices. Demographic data, fracture stability, and operative time were recorded via structured questionnaires. Patients were followed for six months postoperatively and at a final follow-up visit (ranging from 9 to 31 months) to assess Harris Hip Scores and postoperative complications, including limb shortening and device failure. Statistical analysis was performed using SPSS. Results: The incidence of limb shortening and device failure was significantly higher in the LCP group (P = 0.048 and P = 0.014, respectively). Conversely, patients in the DHS group demonstrated significantly higher Harris Hip Scores at both the 6-month follow-up and final evaluation (P = 0.01 and P = 0.018, respectively). Conclusions: Despite some associated complications, DHS remains superior to LCP in terms of functional outcomes and complication rates, reinforcing its role as the preferred method for the surgical management of intertrochanteric fractures.
A Study On Strengthening Of Outpatient Department Services In Government Homoeopathic Hospital At Kekri, Rajasthan
Background: The outpatient department is an important part of the overall running of the hospital. Many patients are examined and given treatment as outpatients before being admitted to the hospital at a later date as inpatients. Therefore, it is essential to ensure that OPD services provide an excellent experience for customers. Educational hospitals play a crucial role in healthcare delivery while simultaneously serving as training grounds for future healthcare professionals. The collegiate hospital of University College of Homoeopathy, Kekri. is newly started hospital by the state Government running in an old CHC building, which is located in the old area of the city and the infrastructure is not sufficient for the current hospital requirements. The current study is specifically useful for the assessment of the health care system in this old building of Homoeopathic hospital at Kekri, and the lacuna found here in old building can be corrected to enhance the quality of OPD services in the under-construction new building. Objectives: The general objective of this study was to assess the different parameters that are helpful to strengthen the Out-patient Department services in Government Homoeopathic Hospital at Kekri, Rajasthan. The specific objectives were to describe functioning of Out-patient Department services in a Government Homoeopathic Hospital at Kekri, Rajasthan, to identify the factors that affect the satisfaction level of patients and to suggest measures to improve and strengthen the quality of Out-patient Department services. Materials & methodology: The study was an institutional cross-sectional observational study, conducted at collegiate hospital of University College of Homoeopathy, Kekri, Rajasthan in between months of April 2024 to June 2024. Total 50 patients and their attendants irrespective of their age, gender and clinical condition, visiting various outpatient departments (OPDs), were examined in the study. All the subjects were provided by the self-made semi-structured patient satisfaction questionnaire (PSQ) at the exit point of the OPD, which was containing eleven statements with their responses ranging from strongly agree (score 5) to strongly disagree (score 1) related to OPD services. Data analysis was done using Microsoft excel with descriptive analysis. Results: The total score of the questionnaire (PSQ) was assessed and it was found maximum number of respondents (44%) were at the score range 20-28 that is not remarkable satisfaction regarding OPD services. Out of 550 responses only 172 (31.27%) responses found strongly agree with all the statements of the questionnaire. Conclusion: A middle range of satisfaction was found among majority of the patients with the services provided in OPD of the hospital. Most of the respondents were satisfied with services provided by the doctors, their reasoning power and their qualifications. For the infrastructure and basic amenities related issues the responses were showing dissatisfaction. Least satisfaction was found in services related to availability of educational material at OPD, accessibility of laboratory and the reports, accessibility of the pharmacy and lastly regarding behaviour of the staff. The patients’ feedback also revealed many insights regarding various aspects, which may improve the quality of services provided to the society.
A Pilot Study On Electromagnetic Neuromodulation Using Emedica Technology For The Clinical Management Of Psychotic Disorders In A 30-Patient Cohort.
Background Psychotic disorders, including schizophrenia and bipolar disorder with psychotic features, are severe mental illnesses marked by disturbances in mood, perception, and cognition. While pharmacotherapy and psychotherapy remain the primary treatments, residual symptoms and adverse effects limit their efficacy. Electromagnetic neuromodulation, particularly via the eMedica system, offers a novel, non-invasive adjunctive approach that may improve clinical outcomes by modulating neuronal activity. Objective To evaluate the clinical efficacy and safety of electromagnetic modulation therapy using the eMedica system in improving symptoms of psychotic disorders in a pilot sample of 30 patients. Methods A 6-week open-label pilot study was conducted on 30 adult patients diagnosed with psychotic disorders according to DSM-5 criteria. Participants received daily sessions of eMedica electromagnetic therapy, targeting psychotic symptoms and comorbid conditions. Each patient followed a three-session daily protocol involving specific programs post-meal. Symptom changes were measured using clinical interviews and validated psychiatric scales, including the Hamilton Depression and Anxiety Rating Scales. Results Seventy-three percent of participants reported notable improvement in mood stabilization. Improvements in sleep quality and reduction in anxiety and depressive symptoms were observed in 67% and 70% of participants, respectively. No major adverse events occurred; minor side effects such as transient tingling sensations were reported in 10% of cases. Patients showed better adherence to routine activities and improved overall well-being by the end of the treatment period. Conclusion Electromagnetic neuromodulation using the eMedica system appears to be a safe and potentially effective adjunctive treatment for managing psychotic disorders. This pilot study supports further investigation through larger, controlled trials to validate its therapeutic benefits and clarify underlying mechanisms.
“An Integrative Approach to Treating Bipolar Disorder: Synthesizing Psychiatric Care with Spiritual Enlightenment, Meditation, and Yoga”
This paper proposes a mixed-method approach to treating bipolar disorder by integrating conventional psychiatric care—including medication and counselling—with spiritual practices such as meditation, yoga, and self-realization. Grounded in personal experience and supported by clinical evaluation, the study explores how spiritual awakening, when practiced alongside medical supervision, can contribute to mood stabilization, symptom management, and overall well-being. The research emphasizes ethical caution, the need for diagnostic clarity, and the value of cultural sensitivity in implementing integrative mental health care.
Existence of Unique Fixed-Point Results in Fuzzy Metric Spaces and Its Utilization
The study of fixed-point theorems within fuzzy metric spaces is pivotal due to its extensive applications across various scientific and engineering disciplines. This paper investigates the existence and uniqueness of fixed-point results in fuzzy metric spaces, addressing a significant gap in current mathematical literature. We present several new theorems that establish conditions under which fixed points exist and are unique, thereby extending and generalizing existing results. Utilizing rigorous mathematical analysis and advanced techniques in fuzzy mathematics, we provide comprehensive proofs to support our findings. The significance of these results lies in their potential applications, which span areas such as systems engineering, computer algorithms, and economic modeling. By demonstrating how these theorems can be applied in practical scenarios, we highlight their utility in solving real-world problems, thereby underscoring the broader impact of our work.
Developing A Trauma-Responsive School-Based Counseling And Life Skills Employment Program For At-Risk Adolescents In Nigeria: A Prevention And Intervention Framework Inspired By The Milwaukee Model.
Chronic exposure to adversity within low-resource educational settings leads adolescents to develop intricate trauma profiles featuring emotional dysregulation along with executive functioning impairments and delayed occupational identity formation. This paper develops a clinically grounded prevention and intervention framework for at-risk Nigerian youth by utilizing the Milwaukee Public Schools' Trauma-Informed Care Model from Wisconsin and focuses implementation in Abia State. This framework combines school-based trauma-responsive counseling with life skills instruction and pre-vocational employment training to support adolescents who face biopsychosocial challenges due to intergenerational poverty and educational neglect along with psychosocial stressors. Based on Bronfenbrenner’s Ecological Systems Theory and SAMHSA's trauma framework, this model transforms schools into therapeutic environments that develop resilience and functional coping while boosting employability. The research uses a mixed-methods approach that integrates qualitative narrative inquiry together with quantitative pre/post outcome assessments to evaluate reductions in trauma symptoms along with improvements in school engagement and workforce readiness. The model also tackles obstacles faced during implementation which include stigma and workforce capacity problems along with maintaining adherence to trauma-informed principles.
The role of HR Analytics in Workforce planning
This conceptual paper workforce explores the important role of HR Analytics in planning, emphasizing how data-driven approaches change human resource management practices. By integrating advanced analytical devices and technologies such as artificial intelligence and machine learning, HR enables analytics organizations to predict the needs of the workforce, adapt talent management to adapt to talent management and increase employee engagement and retention. The study highlights the moral and organizational challenges associated with adopting HR analytics and outlines the importance of transparency, fairness and data privacy. In addition, it identifies emerging research opportunities in implementing HR analytics to develop workforce models including remote and gig employment. Ultimately, this letter argues that today's dynamic business environment required HR analytics to plan agile, responsible and strategically aligned workforces.
Impact Of Drug Therapy And Healthcare Practices On Functional Outcomes And Quality Of Life In COPD Patients: A Real-World Indian Perspective
Background: Chronic Obstructive Pulmonary Disease (COPD) imposes significant limitations on patients’ quality of life (QoL) and functionality. This study assesses the impact of pharmacotherapy and healthcare practices on treatment adherence, functional status, and perceived QoL among COPD patients in a tertiary care setting. Methods: This cross-sectional study was conducted from January 2021 to July 2022 on 612 diagnosed COPD patients. Patient demographics, occupational exposure, indoor and outdoor pollution, treatment adherence, and functional capacity were recorded. QoL was assessed based on symptom burden and daily activity limitation. Results: Most patients were male (82.2%) and aged between 51–65 years. More than 40% reported moderate to severe limitation in routine activities. Suboptimal adherence to inhalational therapy was seen in 41.5%, attributed to cost and lack of education. Women exposed to indoor smoke reported significantly worse symptoms. There was a clear correlation between guideline-based therapy and improved functional scores. Conclusion: In COPD patients, the integration of rational pharmacotherapy with patient education significantly improves functional capacity and quality of life. Special attention must be paid to vulnerable populations such as elderly women exposed to indoor air pollutants.
Impact Of Sense Of Mastery, Marital Strain, And Social Support On Emotional Well-Being And Marital Satisfaction Among Married Couples.
The feeling of mastery refers to a person’s belief in their ability to control and manage life situations. Marital strain is the stress or tension experienced in a marriage. Social support is the help and comfort a person receives from others. Emotional well-being is a state of positive mental health, and marital satisfaction is the happiness and fulfillment in a marriage. Intolerance of uncertainty is the difficulty in dealing with unknown or unpredictable situations. This research investigates how these factors affect married couples. A stronger feeling of mastery improves emotional well-being. Higher social support increases both emotional well-being and marital satisfaction. Marital strain reduces marital satisfaction. People who struggle with uncertainty (low tolerance) weaken the positive effect of mastery on emotional well-being. The study collected survey data from 384 married couples and analyzed it using Structural Equation Modeling (SEM) in AMOS. The results show that improving mastery and social support can enhance mental health and marriage happiness. Managing marital stress and uncertainty helps couples strengthen their relationships with the help of their social networks.
"A Pre-Experimental Study on the Effectiveness of the ‘BUGAR’ Android-Based Application in Reducing Work Fatigue Among Manufacturing Workers in Karawang, Indonesia"
Introduction: Workers often overlook fatigue, and this is also true for their families, worker groups, and managers at the workplace. Fatigue is often viewed as a minor health issue that can be addressed by resting. The goal is to identify the advantages of BUGAR nursing interventions in addressing work fatigue among manufacturing shift workers in Karawang Regency. Methods: This research was designed in quantitative research with a pre-experimental design, with one pre-test and post-test design. The research was carried out at Rejang Lebong Hospital from August to November 2020. 51 workers were chosen using non-random consecutive sampling techniques. Results: The average knowledge of the workers increased from 70.45 to 75.10, attitude improved from 70.16 to 75.86, and skills increased from 67.43 to 74.08. Meanwhile, the level of work fatigue decreased from the previous average value of 67.43 to 22.69. The paired t-test results revealed that the p-value for the variables of knowledge, attitude, skills, and work fatigue is 0.000, indicating that the p-value is <0.05. Conclusion: The BUGAR innovation intervention has a notable impact on the knowledge, attitudes, skills, and reduction of work fatigue in the worker group.
Association Between Hypothyroidism And Dementia: A Systematic Review
Background: Dementia is a disabling syndrome of elderly population characterized by decline in memory, cognitive functions and behavioral changes, gravely reduces the quality of life. Thyroid hormones have vital importance for neural development and their dysfunction (deficiency or increase) can lead to changes in cognitive functions particularly memory decline. Methods: A systematic review was conducted using studies retrieved from PubMed, EMBASE, Google scholar, Science Direct, and Cochrane library, as well as manual retrieval of studies from the bibliographies of selected studies. Original studies published in English in last 20 years (2004-2024) were included. The extracted data was represented on a common form to describe the study setting, population, authors name, year of study, demographic and baseline characteristics of each study. Results: This systematic review examined total Nine studies. Six out of nine studies showed a very strong and significant association between hypothyroidism and dementia. Three remaining studies were failed to show any association in between these two entities. There was female predominance in most of the studies. Results showed that the risk of dementia in hypothyroid individuals increased with increasing age and duration of hypothyroidism. Conclusion: There is a strong association found in between hypothyroidism and dementia (cognitive decline) in most of the studies but still there is a need of large scale prospective randomized studies in future to establish this association.
Evaluation Of Staining Susceptibility Of Aesthetic Restorations Following Mouthrinses – An In Vitro Study
AIM: The purpose of this study is to determine the staining susceptibility of nano-filled composite materials following the use of two different mouth rinses. METHODS AND MATERIALS: The study sample consists of two different nanocomposites of shade A2. 30 samples of nano-filled composites (15 each) with a diameter of 8 mm and thickness of 2mm will be prepared using a metal ring. The samples will be divided into two groups: GROUP A (Tetric N-Ceram), GROUP B (3M ESPE Filtek). Each group has 5 subgroups: Subgroup A: control (normal water), Subgroup B: Betadine 2 % Mint Gargle, Subgroup C: Colgate Plax, Subgroup D: Hexidine, Subgroup E: Peroxyl. All the samples will be immersed in respective mouth rinses for the respective period, then the samples will be placed in distilled water after the testing period and the procedure will be carried out for one week. The color stability differences between the nanocomposites while using two different mouth rinses will be measured by spectrophotometer. Data will be analyzed by ANOVA test. RESULTS: The color difference (ΔE*) of the resin materials ranged between 5.46000 and 0.58400 after one week of assessment. CONCLUSION: Tetric N-Ceram has more staining susceptibility than 3M-ESPE nano-composites. Among the different mouth rinses, betadine has more staining potential followed by Colgate Plax, CHX, and Hydrogen peroxide.
The Influence Of Retail Visual Merchandising On Impulse Buying And Its Psychological Impact Among Young Adults With Psychiatric Disabilities: Implications For Community-Based Rehabilitation
Background: Visual merchandising plays a critical role in influencing consumer behaviour, particularly impulse buying. While the general population's responses to such stimuli are well documented, there is limited understanding of its impact on individuals with psychiatric disabilities. Objective: This study investigates the effects of visual merchandising on impulse buying behaviour among young adults diagnosed with psychiatric disabilities and explores the psychological consequences that may influence rehabilitation and community reintegration. Methods: A mixed-methods design was employed, including surveys (n=120) and in-depth interviews (n=20) with young adults (aged 18–30) diagnosed with mood or anxiety disorders. Simulated retail environments were used to evaluate reactions to visual stimuli, and psychological assessments were conducted post-exposure. Results: The findings revealed that prominent visual merchandising cues such as lighting, display positioning, and promotional signage significantly triggered impulse purchases in 73% of participants. Emotional responses included anxiety (42%), regret (39%), and temporary mood elevation (27%). Participants noted financial stress and self-esteem issues post-purchase. Conclusion: Visual merchandising has a measurable psychological impact on impulse buying behavior in young adults with psychiatric disabilities. Integrating financial literacy, behavioral therapy, and shopping support into rehabilitation programs could promote better coping strategies and recovery outcomes.
Dalit Realities in Kancha Ilaih’s Narrative: A Reading of Untouchable God
Kancha Ilaih is a well-known as one of the Dalit activists. He teaches Political Science at Osmania University, Hyderabad. He is a challenging figure who advocates Dalit ideologies and challenges Brahminical supremacy. He shows in the narrative Untouchable God about upper caste’s inhuman treatment towards Dalit (Pariah boy). And their mental agonies are revealed through the literary work. Brahmins keep them as self-made superior to Dalit people. They become self-made in charge of the social system.
Neural Correlates Of Belief Coding: An EEG Study On Neurophysiological Changes In A Novel Therapeutic Approach
This research examined the neurophysiological impact of Belief Coding®, an innovative integrative therapy to change subconscious beliefs. Sixty women (25–52 years) received Belief Coding therapy under monitoring with a 64-channel EEG system, with a control group of eight women. Outcomes showed significant changes in neural activity, which included a 48% rise in alpha wave coherence, a 58% decrease in incoherent beta activity, a 75% increase in gamma wave synchronization, a 62% increase in delta-theta coupling, and a 62% increase in connectivity of the Default Mode Network. More than 32 key brain regions were targeted during therapy, which indicates that belief change recruits distributed brain networks instead of one "center of belief coding." These results offer initial neurophysiological proof of the effectiveness of Belief Coding therapy to promote emotional regulation, processing of trauma, and restructuring of beliefs through inter-coordinated activation of brain systems.
Multidisciplinary Management in Modern Surgery: Converging Trends in Urology and General Surgery
The practice of modern surgery continues to develop team-based approaches because of complex procedures that combine urological and general surgery specialties. The growth of technical capabilities has led to wider understanding that recovery needs to encompass psychiatric and psychosocial and emotional wellness beyond physical healing. The research examines how integrated surgical teams affect patient clinical results and psychosocial health through surgeon and behavioural health professional and allied healthcare staff collaboration. A 12-month institutional audit using mixed-methods took place at a tertiary academic hospital. The research gathered data from 102 surgical cases that used multidisciplinary coordination while also including staff and patient interviews and satisfaction survey results. The healthcare delivery methods that incorporated teams as part of patient management yielded better outcomes which included diminished hospitalization time combined with decreased postoperative complications and treatment returns as well as better satisfaction rates for patients. A large number of patients exhibited preoperative anxiety as well as postoperative depression especially when psychosocial support programs were inadequate or non-existent. Patients along with healthcare providers both identified emotional readiness alongside effective communication and role identification as beneficial while the complete implementation remained limited by healthcare service shortages and organizational resistance to change and moral dilemmas. The research confirms that surgical pathways must include psychiatric rehabilitation services to achieve comprehensive patient recovery. The integration of mental health care services within surgical facilities simultaneously boosts medical outcomes and supports entire patient health requirements. System-level reforms together with cultural shifts must become essential for establishing interdisciplinary person-centered surgical care throughout every hospital setting.
Comparison Of Growth Patterns In Exclusively Breastfed Vs Formula Fed Infants In First Year Of Life
Background: The influence of early feeding practices on infant growth trajectories has been a subject of increasing interest due to potential associations with long-term health outcomes. This study aimed to compare growth patterns between exclusively breastfed and formula-fed infants during the first year of life. Methods: A prospective cohort study was conducted with 50 healthy term infants (25 exclusively breastfed, 25 exclusively formula-fed) enrolled within the first week of life. Anthropometric measurements including weight, length, and head circumference were obtained at enrollment and at 1, 2, 4, 6, 9, and 12 months of age. Body composition was assessed using bioelectrical impedance analysis at 3, 6, and 12 months. Growth parameters were converted to z-scores using WHO Child Growth Standards. Growth velocity and centile crossing patterns were also analyzed. Results: The feeding groups showed comparable baseline characteristics except for maternal education, which was higher among breastfeeding mothers (p=0.042). Formula-fed infants exhibited significantly higher weight from 4 months onward (p<0.05) and higher weight-for-age and weight-for-length z-scores from 6 months onward (p<0.05), whereas length and head circumference remained comparable between groups. Growth velocity analysis revealed higher weight gain rates in formula-fed infants, particularly during 0-2 months (36.5 vs. 31.8 g/day, p=0.004). Body composition differed significantly, with formula-fed infants showing greater fat mass at all assessment points and higher body fat percentage at 6 and 12 months (p<0.01). Notably, 40.0% of formula-fed infants crossed upward by ≥2 weight-for-length centile lines compared to only 4.0% of breastfed infants (p=0.003). Conclusions: Exclusive formula feeding was associated with accelerated weight gain, higher fat mass accumulation, and more frequent upward centile crossing despite comparable linear growth when compared to exclusive breastfeeding. These distinct growth trajectories highlight the importance of feeding mode as a determinant of early body composition development, with potential implications for future metabolic health.
Study Of Prevalence Of Vesicoureteric Reflux And Renal Scarring In Children With Urinary Tract Infection
Objective: To determine the prevalence of vesicoureteric reflux (VUR) and renal scarring in children with urinary tract infection (UTI) and identify associated risk factors. Methods: A cross-sectional observational study was conducted on 50 children (aged 0-12 years) with confirmed UTI at a tertiary care hospital from January 2023 to December 2024. All children underwent renal-bladder ultrasonography, voiding cystourethrogram (VCUG), and dimercaptosuccinic acid (DMSA) renal scintigraphy. VUR was graded according to the International Reflux Study Committee classification, and renal scarring was defined as persistent defects on follow-up DMSA scan performed 6 months after the acute infection. Risk factors for renal scarring were identified using multivariate logistic regression analysis. Results: The study population comprised 36 females (72%) and 14 males (28%), with most children (46%) aged 1-5 years. The overall prevalence of VUR was 42%, with unilateral reflux (26%) being more common than bilateral reflux (16%). VUR prevalence was highest in infants under 1 year (55.6%) and decreased with age. Renal scarring was detected in 34% of children, with unilateral scarring (70.6%) predominating. A strong association was found between VUR and renal scarring (61.9% vs. 13.8%, p<0.001), with all children with high-grade VUR (Grades III-V) developing renal scarring compared to only 27.3% with low-grade VUR. Multivariate analysis identified high-grade VUR (OR: 8.7, p<0.001), recurrent UTIs (OR: 3.2, p=0.001), age less than 1 year (OR: 2.8, p=0.003), and delayed antibiotic treatment (OR: 2.5, p=0.015) as significant independent risk factors for renal scarring. Conclusion: VUR and renal scarring are common in children with UTI, with a significant association between high-grade reflux and permanent renal damage. Early diagnosis and prompt treatment of UTIs are critical, especially in high-risk groups, to prevent long-term renal sequelae.
Understanding The Offender: Behavioral Evidence Analysis In Forensic Interrogation – Methodologies, Emerging Trends And Applications
Understanding criminal behavior is a cornerstone of forensic investigations, and Behavioral Evidence Analysis (BEA) has emerged as a crucial tool in forensic interrogation. By combining insights from psychology, criminology, and investigative science, BEA helps law enforcement professionals assess deception, analyze cognitive patterns, and identify behavioral inconsistencies in suspects. This paper delves into the methodologies that shape BEA, highlighting its evolution from traditional interrogation techniques to modern, data-driven approaches. With advancements in artificial intelligence, neuropsychology, and biometric analysis, forensic interrogation has become more precise and evidence-based. However, while these technologies offer promising results, ethical concerns surrounding coercion, psychological manipulation, and legal admissibility remain at the forefront. This study explores the impact of BEA across various domains, including criminal investigations, counterterrorism, corporate fraud, and cybercrime. We assess BEA’s effectiveness in differentiating between truthfulness and deception by analyzing real-world case studies and recent research. Finally, we examine future directions, particularly the integration of AI-driven behavioral analysis and neuroscience, which may redefine the landscape of forensic interrogation.
Navigating Constitutional Change: A Cross-Jurisdictional Examination of Amendment Procedures in India, France, and the USA
This research paper conducts a comparative analysis of the constitutional amendment mechanisms in India, France, and the United States, highlighting the delicate balance between rigidity and flexibility essential for constitutional longevity and adaptability. The paper explores the distinct frameworks each country employs to amend its constitution, reflecting on how these systems uphold or challenge democratic principles and responsive governance. By examining the procedural intricacies and historical amendment instances in each context, this study elucidates the underlying principles that govern the modification processes and assesses their effectiveness in responding to evolving socio-political demands. This comparative approach not only sheds light on the diverse strategies nations utilize to maintain constitutional relevance in changing times but also offers insights into the broader implications of amendment rigidity versus flexibility on global constitutionalism.
Comparision Of Visual Outcome And IOP Changes Before And After Nd-Yag Laser Capsulotomy In Patients With Posterior Capsular Opacification
Background: Posterior capsular opacity (PCO) is the commonest longterm complication of cataract surgery. PCO present with gradual decrease in visual acuity after successful cataract surgery. Various methods employed for the prevention of PCO like capsular polishing, implanting IOL’s with convex posterior surface and surface-modified lens have not been shown to be very successful in long term follow up. All my patients underwent Nd:YAG laser capsulotomy for Posterior capsular opacity, which is a noninvasive, effective and relatively a safe technique for PCO management. Hence, in this present study every effort is made to study the visual outcome and IOP changes before and after Nd: YAG LASER capsulotomy. Objective: To compare the visual outcome and IOP before and after ND-YAG laser capsulotomy in patients with Posterior Capsular Opacity Methodology: A total of 100 patients with posterior capsular opacification attending the Department of Ophthalmology, Vinayaka Missions Medical College and Hospital, Karaikal who gave consent for the research purpose were taken up for the study. Patient’s details including age, sex, and surgical history was recorded. Complete Ocular examination was done before ND-YAG capsulotomy including Best corrected visual acuity (BCVA), Anterior segment examination using Slitlampbiomicroscopy, Retinoscopy, Intraocular pressure measurement using Applanation Tonometer and Posterior segment examination includes dilated fundus examination with Slitlamp biomicroscopy using +90D was recorded. Statistical analysis was performed using SPSS software. Results: This prospective study was conducted in the Department of Ophthalmology at Vinayaka Missions Medical College, Karaikal. On approval by ethical committee, 100 patients with Posterior Capsular Opacification recruited after obtaining informed consent.The result of the study showed that, maximum number of patients had developed Elschnig pearl type of PCO i.e. 64 patients (64%). After 1 week ND YAG laser capsulotomy 84% (84 patients) of patients showed improvement in best corrected visual acuity. The results of the study showed that, all the 100 patients showed a temporary rise in the intraocular pressure values after ND YAG laser capsulotomy which return to near normal of the base line values at the 1 week of follow up. Conclusion: The results of the study showed that Complications with Nd:YAG laser capsulotomy are very minimal and only transient elevation of IOP, which can be managed with topical Timolol maleate 0.5% drops on outpatient basis with regular follow up. Improvement in visual acuity with Nd:YAG laser capsulotomy is excellent and complications with Nd:YAG laser capsulotomy are minimal and transient in this study. Hence concluded that Nd-YAG laser capsulotomy is a noninvasive, effective, relatively safe technique to manage posterior capsular opacity and it does not require patient hospitalization.
Edsurance: A Revolutionary Educational Guidance Platform For Holistic Student Development In India
India's educational system still suffers structural inefficiencies notwithstanding its demographic advantage and the National Education Policy (NEP) 2020, especially in terms of offering complete student support. Though still mostly focused on academic output, emotional intelligence, ethical values, vocational training, and tailored counselling are not sufficiently included in conventional schooling. Closing these long-standing gaps was the goal behind Edsurance, a copyright-protected platform with AI capabilities (Diary No: 2401/2025-CO/L) [8]. Comprising eighteen linked modules encompassing skill development, career mentorship, exam preparation, spiritual learning, and mental wellness, this digital ecosystem responds to a significant national crisis. Given that less than 5,000 licensed school counsellors exist in India [2] and more than 65% of Indian students are under 25, there has never been a larger demand for such a platform. The study examines how Edsurance provides one-stop shopping for moral, emotional, and intellectual guidance. Statistical data from UNICEF, ASER, and NCRB helps one to place the demand for the platform [1][3][6]. Edsurance turns out to be a scalable, reputable strategy that not only improves NEP 2020 [4] but also creates a new benchmark for digital infrastructure for student growth.
A comparative evaluation of the efficacy of herbal mucoadhesive patch with benzocaine mucoadhesive patch to relieve pain associated with placement of elastomeric separators.
Aims: The Purpose of this study was to evaluate the efficacy of benzocaine and herbal mucoadhesive patch in reducing pain caused by elastomeric separators. Materials and methods: A sample size of 40 patients were selected for the study. Elastomeric separators were placed mesial and distal to first maxillary molars in both quadrants and the patches were placed buccal mucosa above the 1st maxillary molars. The medication patch and the placebo patch were distributed randomly among the two groups of 20 patients each. For both of their first maxillary molars, the patients were given Visual Analogue Scales (VAS). The Mann-Whitney U test and Krausal test analyses were done after data collection. The patient recorded readings every six hours beginning 30 minutes after the patch insertion. The mucoadhesive drug and placebo patch was replaced after 48 hours and every six hours, the reading was remarked, and the final marking was conducted at 72nd hour and mucoadhesive patch was replaced. Results: There was statistically significant reduction in pain. when mucoadhesive drug patch was compared with the placebo patch. It was seen that benzocaine was most effective at 6th, 48th ,72nd hour, followed by quercetin patch which was effective at 6th, 48th ,72nd hour. When two drug patches were compared it was observed that benzocaine was significantly effective in relieving pain caused due to separators. Conclusion: It can be concluded from the study that benzocaine and quercetin patches were effective in reducing pain caused by elastomeric separators as compared to the placebo patch. The use of benzocaine patches was most effective followed by a quercetin mucoadhesive patch.
A Study on Paradigm shifts of Tourism Industry in India
Background: The Indian tourism industry has undergone significant transformation between 1990 and 2023, shaped by economic liberalization, global outreach, policy reforms, and digital innovations. This period witnessed a transition from a relatively closed, heritage-centric model to a diversified, technology-integrated tourism economy. Methods: This study adopts a comprehensive review methodology, relying on secondary data from credible national sources such as the Ministry of Tourism and the Reserve Bank of India, and international organizations including the UNWTO, WTTC, and the World Bank. Analytical tools such as trend analysis, CAGR computation, and policy content review were employed to assess the evolution of Foreign Tourist Arrivals (FTA), Foreign Exchange Earnings (FEE), and the impact of government interventions. Results: The findings highlight three key developmental phases, including 1990-2000 (post-liberalization restructuring), 2001-2010 (global marketing and branding through campaigns like Incredible India), and 2011-2023 (digital transformation and post-COVID resilience). FTA and FEE have grown substantially over these years, with minor setbacks during global crises. Government initiatives, visa reforms, and public-private partnerships have positively influenced growth. Simultaneously, the sector faces challenges including infrastructure limitations, sustainability issues, and seasonal dependence. Conclusion: India's tourism sector holds immense potential. With continued focus on smart tourism, niche offerings, and inclusive policies, the industry is poised for sustained and resilient expansion in the coming years.
Phenotypic detection of inducible clindamycin resistance by D-test in Staphylococci from various clinical samples
Background: Staphylococcus aureus is a major opportunistic human pathogen causing many clinical infections. Three MLSB phenotypes are known in S. aureus, a constitutive resistant phenotype (cMLSB), a clindamycin-susceptible phenotype in vitro with inducible resistance in vivo (iMLSB), and a clindamycin-susceptible and macrolide-steptogramin B-resistant phenotype (MSB). Method: This prospective-observational study was carried out in Department of Microbiology, NIMS medical college, Jaipur, Rajasthan from July 2023 to Sept 2024. A total of 50 Staphylococci were isolated from different types of samples. All the Staphylococcus aureus isolates that were resistant to erythromycin were tested for inducible Clindamycin resistance by double disk approximation test (D-test) as per CLSI guidelines. Result: A total of 50 Staphylococci isolates, MSSA were 18 (36%) followed by CONS 12 (24%), MR-CONS 12 (24%) and MRSA 8 (16%). Out of total 50 isolates, 17 (34%) showed inducible resistant by D-test. In which MSSA were 3 (18%), CONS 5 (29%), MR-CONS 4 (24%) and MRSA 5 (29%). Inducible resistance was observed among various clinical samples like, Blood samples 10 (60%) followed by Pus 5 (30%), Wound Swab 1(5%), and High Vaginal Swab 1(5%). Discussion: In this study we found 34% inducible clindamycin resistance by D-test. Similar, findings observed in various studies also. Conclusion: Highest percentage of inducible resistance found in isolates from Blood sample. Clinical microbiology laboratories should report inducible Clindamycin resistance in Staphylococcus aureus and D-test can be used as a simple, auxiliary and reliable method to Delineate inducible and constitutive Clindamycin resistance in routine clinical laboratories.
Early Black Autobiography: The Suffering of Individual and Community: Frederick Douglass autobiography
Autobiography in the 19th century onwards became a tool in the hands of the sufferers and an instrument for resistance and revolution. The voiceless and subalterns received a voice through the genre to express their agonies; pains and it emerged as a platform to openly blame the establishments. Slavery the darkest reality of Afro American political, social and economic discourse came into picture with the spread of Autobiographies. Life and Times of Frederick Douglass- Frederick Douglass is the milestone autobiography of world literature in general and black Afro Americans in particular. Frederick Douglass who lived as a slave and later served honourably as the United State Marshall in the Columbia District put his memories in his autobiography published in 1881. He could give details about his life as a slave and his escape from slavery in the third volume of his autobiography which he could not do in first two volumes under the fear to his life from his masters. The autobiography is a vivid picture of a horrible account of slavery and its dark history during the time of slavery. The autobiography is filled with unbelievable and tragically intensified experiences of Douglass as a slave. The research paper focus on the struggle the writer went through as an individual and a part of a vast community whose destiny was tied with the slavery, it is an effort to analyse the conditions of the slaves and how the autobiography became inspiration to all hopeless and powerless slaves to overcome fear, trauma and resist with the evil of slavery.
Hybrid AI Model for Soil Fertility Prediction and Fertilizer Optimization
Excessive use of pesticides and fertilizers in agriculture has led to issues such as soil erosion, water pollution, low microbial activity, and rising production costs [3]. This is crucial for sustainable agriculture, as it determines crop growth, nutrient balance, and environmental protection. However, standard methods of soil testing include laboratory tests; hence, they are time-consuming, costly, and not readily available to farmers. Such issues can cause delays in decision making, which leads to inefficient fertilizer use and long-term soil degradation. To address these issues, an AI-based Soil Fertility Prediction System was designed. The system uses data from Soil Health Cards (SHC), current weather data, and leaf colour chart (LCC) analysis to make timely and accurate recommendations. The system uses LSTM, a deep learning algorithm, to predict soil parameters, such as pH, nitrogen, phosphorus, and potassium, and weather parameters [8] such as temperature, humidity, rainfall, and wind speed. EfficientNetB0, a light deep-learning model, considers leaf images captured by farmers to detect nitrogen deficiency using LCC-based classification. [2] Both models are merged using a weighted average method, which gives a Soil Fertility Score (SFS) representing soil health and optimal fertilizer requirement. According to this score, farmers provide detailed instructions on how many nutrients are to be utilized. This prevents the overuse of chemicals and allows crops to grow well. The system is web deployable, thus providing easy access to farming communities. With computer vision and deep learning, this method allows for better decisions, minimizes soil damage, and allows sustainable farming.
Comparative analysis of preoperative CECT scan with histopathology in oral cavity malignancies
Background: Oral cavity carcinomas carries significant morbidity and mortality particularly among the young male population in the developing world due to habitual usage of tobacco and betel quid. The physical examination allows for the visual assessment of the superficial lesions, however, the extent of the deep structure could not be done. The evaluation of the spread of these tumours to the adjacent structures is crucial for the diagnosis, staging and planning for appropriate treatment strategy. Hence cross-sectional imaging like MDCT and MRI plays a vital role in diagnosis, in assessing the spread and staging of these tumours. Objectives: The primary objective of this subject is to determine the comparison of CECT in the detection of the primary T stage and nodal involvement of primary oral cavity tumours with histopathlogical findings. Methods: This study is a restrospective, analytical observational study carried out on 42 patients diagnosed with carcinoma of the oral cavity in our tertiary care hospital for 6 months. MDCT plain and contrast were performed preoperatively for all patients having oral cavity carcinomas to allow for better visualization and characterisation of primary lesions and assess the nodal morphology and invasion of vascular structures. Data from the intraoperative surgical and histopathological findings were collected and compiled and finally correlated with the MDCT findings. Results: IBM SPSS (Version 26.0) (Released 2020, IBM Corp. New York, US) was used for statistical analysis. Totally fourty-two patients were included in the study of which 61% are females and 39% are males. The commonest age group of presentation was between 50 to 60 years. The t stage of the primary tumor in our study was identified with a 93% accuracy by MDCT. Sensitivity, Specificity, and accuracy of MDCT in identifying osseous erosion were 100%, 80% and 87% respectively. Node involvement by the tumor was identified by MDCT with a sensitivity of 89%, specificity of 97 % and accuracy of 97%. Conclusion: Preoperative assessment by multidetector computed tomography is very crucial for the accurate staging of primary oral cavity tumours which helps the treating physicians in establishing the appropriate treatment strategy in the management of these patients.
Prevalence Of Common Clinical Conditions and Outcome in Pediatric Medical Intensive Care Unit in Kerala
Background: The study aimed to assess the prevalence of common clinical conditions and the outcome of children admitted to the pediatric medical intensive care unit of a tertiary care centre in Kerala. Methods: A prospective observational study was conducted in the Pediatric medical Intensive care unit of a tertiary care centre over 3 months from January 2025 to March 2025. The data was analyzed using the Statistical Package for Social Sciences version 25. A chi-square test was used to test for the significance of the association; a p-value of less than 0.05 was considered significant. Results: A total of 226 of these patients met the inclusion criteria and were included in the study and analysed. Of these, children between 5-12 years (35.39%) accounted for the largest number, males overcounted females at 53.98%. Respiratory illnesses, neurological disorders, and hemato-oncologic conditions were the most common reasons for admission. Children who stayed in the intensive care unit for 2–7 days accounted for 43.36%. 12.38% of children needed invasive mechanical ventilation, and among them, 6 were undergoing tracheostomy. 13.27% of children had died, and 86.73% were transferred to the ward. Significant associations were found between mortality and admission source, length of stay, renal replacement, and ionotrope support. Conclusions: The knowledge of common clinical conditions and outcomes of children admitted to the pediatric medical intensive care unit and the association between socio-demographic characteristics helped to plan certain nursing interventions to improve the outcome of the patients in the critical care area.
AI-Powered Skin Cancer Detection Using A CNN-Transformer Hybrid Model
This study details the development and implementation of a deep-learning-based automated skin analysis skin scan application. A hybrid model combining EfficientNet and Vision Transformer (ViT) was proposed to increase the accuracy of lesion classification. While EfficientNet retrieves fine-grained spatial characteristics, ViT gathers global contextual links and performs better in terms of accuracy than ViTs and solo CNNs, especially when it comes to identifying difficult cases. The model was trained and validated using the HAM10000 dataset. This method reduces dependency on conventional dermatological treatments by providing an easy-to-use and accessible AI-driven tool for early skin cancer detection.
Automated Brain Tumor Detection And Localization Using YOLO-Based Deep Learning Algorithm
Classifying brain diseases is a very difficult task because of their complexity and sensitivity. Developing an efficient treatment plan calls for early detection and diagnosis since brain tumors are severe and occasionally fatal. A key medical imaging tool, magnetic resonance imaging (MRI) enables the thorough, non-invasive view of the internal structures of the brain. Magnetic resonance imaging (MRI) is essential for diagnosing and treating brain tumors. Beginning with dataset preprocessing, the approach is applicable to MRI scans and clinical data from individuals with various brain disorders, including tumor and non-tumor cases. The dataset consists of training and testing sets. Detecting MRI tumors calls for several procedures including feature extraction, classification, and image post-processing. The system uses the YOLO (You Only Look Once) algorithm with the CNN model, a pre-trained model using the concept of transfer learning, for classifying and detecting brain tumors. The proposed framework not only improves the performance of training a better model by using the pre-trained model but also refines the dataset for better accuracy by using thresholding and increases the number of images in the dataset by using data augmentation. Early results indicate that the family of YOLO models outperforms earlier architectures since it uses a compound coefficient with a constant ratio to scale all depth, width, and resolution of an image. The findings also showed that by increasing the baseline architecture, the model can capture complex features, and thus the overall performance of the system is significantly improved.
“A True Experimental Study To Assess The Effectiveness Of Raj Yoga Meditation On Psychological Well-Being Among Old Age People In Selected Areas Of Maharashtra.”
Background of the study: Yoga is a science which has been practised in India from over thousands of years. Besides its spiritual achievements, the practice of yoga is accompanied by a number of beneficial physiological effects in the body. Aim of the study to assess the effectiveness of Raj Yoga Meditation on psychological well-being among old age peoples. Methods: The quantitative, true experimental research design was used to conduct this study, data were conducted from demographic variables and B Ryff’s Psychologicla wellbeing scale. The data was analyzed by descriptive and inferential statistics. Results: In experimental group pre-test level of Psychological wellbeing range was 111 to 218, Mean and SD of level of Psychological wellbeing was 172.50 ± 35.27. In control group pre-test level of Psychological wellbeing range was 108 to 218 Mean and SD of level of Psychological wellbeing was 168.06 ± 43.91. The post-test psychological wellbeing scores, In experimental group 14 (46.67%) old age population were having high psychological wellbeing, 10(33.33%) old age population were having average psychological wellbeing, 06(20%) were having very high psychological wellbeing. Similarly in control group 14(46.67%) old age population were having average psychological wellbeing, 08(26.67%) old age population were having high psychological wellbeing and 04(13.33%) old age population were having very high psychological wellbeing. In experimental group post-test level of Psychological wellbeing range was 187 to 223 Mean and SD level of Psychological wellbeing was 201.96± 28.57 and in control group, post-test level of Psychological wellbeing range was 126 to 218 Mean and SD level of Psychological wellbeing was 172.33±41.26. To evaluate the effectiveness of Raj Yoga on level of Psychological wellbeing among old age population in a selected areas of Maharashtra and to find the significant mean difference between pre-test and post-test level of Psychological wellbeing in experimental and control group, The findings shown that in the experimental group, the mean difference with SD was 29.46±8.64 and paired t test value was 14.69, df=29, and p value was 0.001 found significant. In the control group the mean difference with SD was 4.26±5.34, paired t test value was 2.12 df=29, and p value was 0.03. which shows that there was no significant difference between the before and after. The calculated Chi square (χ2) value for the educational status ((χ2 = 11.26, df-=3, p<0.05, S*) and previous occupation (χ2 = 8.69, df=3, p<0.05, S*) this indicate that the educational status and previous occupation were found association with the pre-test psychological wellbeing scores in experimental group. For the control group there was no association found. Conclusion: The study concludes that the Raj yoga mediation was effective in enhancing the psychological wellbeing among old people.
Assessment of Attitude and Practice Regarding Diabetic Foot Ulcer Among Nurses in Jordan
Background: Diabetes mellitus (DM) is one of the leading causes of death worldwide, and diabetic foot ulcers (DFUs) are a chronic complication that can lead to amputations and reduce the quality of life for patients with diabetes. Purpose: This study aimed to assess the attitudes and practices of Jordanian nurses regarding diabetic foot ulcers and to explore the potential relationship between these attitudes and nurses’ clinical practices as well as their demographic characteristics. Methods: We conducted a descriptive, cross-sectional study involving a sample of 256 nurses from nine public hospitals in central, northern and southern Jordan. Participants completed the “Diabetic Foot Ulcer Knowledge, Attitudes, and Practices Questionnaire.” Results: Half of the participants exhibited negative attitudes (52%; n = 132) and inadequate practices (50.4%; n = 129) regarding diabetic foot ulcers. Nurses’ attitudes were influenced by age group (41–50 years; OR [odds ratio] = 3.891; p = 0.009) and training (OR = 0.576; p = 0.048). Additionally, training nurses through a diabetic foot ulcer course significantly improved their attitudes (p = 0.042). Furthermore, nurses’ practices were influenced by gender (p = 0.040) and working area (OR = 5.712, p = 0.026). Statistical significance was established at p < 0.05. Conclusion: Jordanian nurses demonstrate poor attitude and inadequate practices regarding diabetic foot ulcers. Thus, healthcare organizations should encourage nurses’ participation in both theoretical and practical training programs to improve their competencies.
Design And Development Of Clarithromycin-Loaded Microspheres For The Treatment Of H Pylori Infection
A promising strategy for improving the bioavailability and therapeutic effectiveness of drugs with absorption windows in the upper gastrointestinal tract is the use of gastro-retentive drug delivery systems (GRDDS). A macrolide antibiotic clarithromycin is frequently used to treat Helicobacter pylori-induced peptic ulcers and upper respiratory tract infections. However, the creation of a controlled-release formulation is required due to its short biological half-life and variable bioavailability. The aim of this study was to design and optimize a gastro-retentive formulation of clarithromycin-loaded microspheres using a spray drying technique. he formulation that was optimized demonstrated prolonged drug release characteristics, appropriate physicochemical features, and good entrapment efficiency. Better bioavailability and patient compliance were indicated by the in vitro drug release profile, which showed a regulated release of clarithromycin over a 6-hour period. A promising method for boosting clarithromycin's therapeutic efficacy is the new gastro-retentive microsphere formulation, which could be a useful treatment alternative for individuals suffering from respiratory tract infections.
The Obesity Equation: Unpacking the Role of Changing Food Consumption Patterns
Overweight and obesity are now recognized as serious global public health concerns. In Kerala, a state known for its high social development standards, lifestyle diseases—particularly obesity—are on the rise. This growing issue is closely linked to metabolic syndrome, which includes conditions like high blood pressure, diabetes, and elevated cholesterol levels.Non-communicable diseases (NCDs) such as cancer, heart disease, and respiratory conditions are increasing rapidly, placing a heavy burden on the state's healthcare system and reducing productivity. Poor diet, sedentary lifestyles, alcohol consumption, and smoking are key contributors, and these issues are now affecting children and adolescents as well as adults. Despite numerous studies on obesity and its causes, there has been little focused research on adult obesity in Kerala. This study aims to assess the prevalence of overweight and obesity among adults and explore the socio-economic and consumption patterns driving this trend. Adolescent obesity, influenced by changing socio-economic conditions and dietary habits, remains an under-researched area. Addressing it is essential—not only as a matter of human rights but also for the long-term economic and health benefits to society. Investing in adolescent health ensures a healthier, more productive future population and reduces the burden of disease in later life.
Empirical Insights Into Holistic Healing: Chronic Lower Back Pain Management Through Yoga And Auricular Acupressure
Background: Chronic lower back pain represents one of the most prevalent musculoskeletal disorders globally, significantly contributing to functional disability across diverse occupational groups. It is not limited to individuals engaged in physically demanding labour but is increasingly observed among those with sedentary lifestyles and desk-bound professions. This condition affects a substantial segment of the population, posing serious implications for public health and workforce productivity. Aim: This study aims to evaluate the therapeutic efficacy of Auricular Acupressure and Yogic interventions in the management of chronic lower back pain among affected individuals. Methods: A total of 120 participants were selected from the rural population of Mahender-Grah district, India, using purposive convenience sampling. These participants were randomly assigned into three groups (with the parameters: alpha = 0.05, power = 0.95 and effect size (ES) = 0.82) a Yoga intervention group (n = 40), an Acupressure intervention group (n = 40), and a control group (n = 40). The intervention period spanned six months. Participants in the Yoga group engaged in structured Yogic practices five days per week, allowing for two rest days. In the Acupressure group, auricular seeds were applied once every ten days for the duration of the intervention. Pre- and post-intervention assessments were conducted using the Oswestry Low Back Disability Questionnaire or Oswestry Disability Index (ODI) to evaluate lower back disability, while the Angle of Flexion (AOF) was measured using a standard manual goniometer. The research was conducted at the Department of Yoga, Central University of Haryana, under the supervision of the designated research supervisor. Result: The findings of the study showed a significant improvement in pain conditions and disability of lower back, with auricular group showing slightly greater improvement (p=0.00426). Conclusion: Both Yoga and Acupressure therapies showed their effectiveness in pain and disability of lower back. These interventions could serve as cost effective health care.
Effect Of Plyometric Training on Performance and Agility in Quadriceps and Hamstring Muscles Among Young Soccer Players
Background: This study examines the effects of plyometric training on performance and agility in the quadriceps and hamstring muscles among young soccer players. The significance of performance and agility in soccer, coupled with the potential benefits of plyometric training, motivated this research. Materials & Methods: A randomized controlled trial was employed with young soccer players as participants. The intervention involved a structured plyometric training program for the Plyometric Training Group, while the Control Group maintained their regular soccer training. Pre-test and post-test assessments were conducted for agility, quadriceps girth, and pain intensity. Statistical analysis included descriptive and inferential statistics. Results: Before the intervention, both groups had similar baseline scores for agility, quadriceps girth, and pain intensity. After the plyometric training program, the Plyometric Training Group exhibited significant improvements in agility, evidenced by reduced test times. Additionally, the Plyometric Training Group showed increased quadriceps girth, and participants reported a significant reduction in pain intensity. Conclusion: The findings support the effectiveness of plyometric training in enhancing performance and agility in young soccer players. Plyometric training resulted in improved agility, increased quadriceps girth, and reduced pain intensity. Coaches and sports trainers can consider incorporating plyometric training into training regimens to optimize the athletic performance of young soccer players.
Substance Use Patterns In Patients Reporting To The State Drug Dependence Treatment Centre Of Haryana, During The Covid-19 Pandemic.
Substance use disorders (SUDs) pose a significant public health challenge in India, with treatment centers facing barriers to effective case registration and providing effective management. This retrospective study analyzed data from the State Drug Dependence and Treatment Centre (SDDTC), Rohtak, during the COVID-19 pandemic (March 2020–July 2020), to understand the substance use pattern and treatment seeking. Sociodemographic, clinical, and treatment-related data were examined using SPSS. Findings revealed key predictors of poor follow-up, including socio-economic and pandemic-related disruptions. The study underscores the need for targeted interventions and standardized follow-up protocols to improve treatment retention and outcomes in addiction services.
Assessment of Pre and Post Interventional Study on Knowledge, Attitude and Practice Among PCOS Women in Government Hospital, Saharanpur, U.P.
Polycystic Ovary Syndrome stances as a widespread endocrine disorder which affects females between reproductive years, yet awareness and management practices remain inadequate in many regions. This study aimed to assess the efficiency of a structured educational intervention on the knowledge, attitude, and practice (KAP) levels related to PCOS among women attending a government medical college in Saharanpur, Uttar Pradesh. A total of 138 women diagnosed with Polycystic Ovary Syndrome participated in this pre-post interventional study. Baseline KAP data were collected through a validated questionnaire, followed by a health education session comprising lectures, visual aids, and distribution of informational materials. Questionnaire after the intervention to evaluate changes in participant responses. The research showed significant progress in every evaluation area. Knowledge scores exhibited the biggest improvement with additional developments detected in both attitude and practice. Paired t-tests executed statistical evaluation which validated the significant changes (p < 0.05). Structured health education developed specifically for the context delivers essential benefits which help address misconceptions and encourage better decision-making and better healthcare practices among women who have PCOS. The research suggests outpatient services should implement these programs as a regular component to enhance early detection and better disease management results.
A Dual Evaluation of Dietary Habits and Depression Severity Among Patients Using HAM-D at S.M.M.H Medical College Saharanpur U.P
Background: -Depression is a growing global health concern, particularly in low- and middle-income countries like India. Despite increasing interest in nutritional psychiatry, there is limited research exploring the relationship between dietary habits and depression severity in semi-urban and rural Indian populations. Aim: -This study aimed to assess the dietary patterns of psychiatric outpatients and analyse their association with the severity of depression, as measured by the Hamilton Depression Rating Scale (HAM-D), at S.M.M.H. Medical College, Saharanpur. Methods: -A cross-sectional observational study was conducted involving 162 adult patients attending the psychiatry outpatient department. Participants were selected through convenience sampling. Data were collected using structured interviews, a dietary questionnaire, and the HAM-D scale. Results: -More than half of the participants (54.32%) exhibited moderate depression. Healthier dietary behaviours, especially higher frequency of fruit intake and less meal skipping, were associated with lower HAM-D scores. Among the dietary factors analysed, only fruit intake frequency and meal skipping showed statistically significant associations with depression severity. Conclusion: -The findings suggest that certain dietary habits, particularly regular fruit consumption and consistent meal patterns, may be linked to lower depression severity. These results highlight the importance of integrating nutritional counselling into mental health care. Further longitudinal studies are needed to better understand the causal pathways and to inform public health interventions.
Role of MRI in Assessment of First Seizures in Pediatric Patients
Background: When a Pediatric patient has their first seizure, it's a medical emergency that calls for immediate answers about what's causing it. MRI shines as the go-to apparatus for spotting brain anomalies linked to these episodes. Objective: This review digs into when doctors should order an MRI, the best timing for it, what it typically reveals, and why it matters for pediatric having their first seizure, whether triggered or not. Methods: The scoured studies from 2015 to 2025, zeroing in on research about MRI findings in Pediatric patient aged 1 month to 18 years who had a first-time seizure. Results: Doctors often turn to MRI when seizures start in one part of the brain, when neurological exams raise red flags, or when recovery takes too long. It frequently uncovers issues like malformed brain tissue, tumors, scarring in the temporal lobe, or damage from lack of oxygen. These discoveries guide decisions about surgery or diagnosing epilepsy. Conclusion: MRI is a game-changer for figuring out what’s behind a pediatric’s first seizure, especially when signs point to something serious. Smart imaging strategies and pediatric-friendly sedation make it both effective and safe.
"In Vitro Evaluation of Antifungal Activity from Leaf Extract of Cassia Fistula and Psidium Guajava"
Complicating their already limited efficacy and rising resistance to current antifungal medications, fungal infections pose a significant risk to human and agricultural health. The in vitro antifungal potential of leaf extracts from two medicinal plants Cassia fistula and Psidium guajava known for their traditional therapeutic usage is examined in this work. Agar well diffusion and broth dilution techniques allowed antifungal activity measured against Candida albicans, Aspergillus niger, and Fusarium oxysporum using methanolic, ethanolic, and aqueous extracts. Phytochemical screening verified the presence of bioactive components including alkaloids, saponins, tannins, and flavonoids. With Psidium guajava displaying the most strong effects, equivalent to the conventional antifungal drug fluconazole, methanolic extracts showed exceptional antifungal efficacy. These results confirm the possible use of certain plant extracts in the creation of substitute antifungal treatments.
The Psychological Impact of High-Stakes Testing: Investigating the Effects of NEET/JEE Pressure on Students; Mental Health and Well-Being
Stress in the classroom is becoming more common among students appearing for high-stakes exams such as NEET and JEE, which directly affects students' mental health and self-esteem. This study explores the relationship between AS and psychological well-being and focuses on the effect of stress on both mental health outcomes and SE among students. For this study, a survey conducted among 385 students from Jammu City, J&K, has been taken as the fundamental data collection tool in standardized scales based on a quantitative research design. This study used statistical tools such as SPSS and Excel, as well as regression and correlation as a technique for analysis of data. It is found that academic stress affects mental health directly because stress depicts 31.1% of the variance. Furthermore, there is also a moderate positive correlation between AS and SE In other words, greater stress overlaps with higher self-esteem. It was also seen that the males and younger age group, that is, the 18–19-year-olds, face more stress with poorer mental health outcomes. However, these results are restricted to an urban sample, and the cross-sectional design limits their generalizability; therefore, more future research is needed to involve different populations and long-term effects. There is a need for focused interventions to deal with academic stress to improve their mental well-being.
Navigating Emotional Diaspora: The Interaction of Trauma and Identity in “The Namesake”
In “The Namesake”, ‘Lahiri’ presents a moving and perceptive examination of identity, grief, and the immigrant experience by deftly capturing the diaspora’s emotional agony and complex realities. The book provides an insightful commentary on the persistent effects of cultural displacement and the search for belonging in a world continuously changing from the “Ganguli” family's perspective. ‘Ashima Ganguli's’ emotional anguish is exemplified by her deep loneliness and isolation in a distant environment. Separated from her family and familiar surroundings, she struggles to adjust to American society, relying on Bengali customs to help her cope with her feelings of loss and displacement. Her loneliness is apparent, representing the immigrant's sense of being stuck between two cultures. This paper aims to highlight the theme of emotional diaspora of the female protagonist, the mother of the central character of this psychologically twirling novel. The study of this research is more analytical and descriptive to justify the psychological perception of the society and the females made by the society as well. The study will focus on the traumatic and diasporic theory. As ‘Ashima Ganguli’ is the most evident psyche standing in the courts of emotional diaspora along with the traumatic perception of the main role, ’Gogol’, and his seasonal relationships with his identity and his parents.
Evaluation of Lumbar Disc Degeneration in Postmenopausal Women’s using 1.5Tesla MRI
Lumbar disc degeneration (LDD) is a major cause of chronic low back pain (LBP), particularly in postmenopausal women, due to hormonal and age-related changes. As estrogen levels decline after menopause, degenerative processes in the intervertebral discs are accelerated, leading to reduced hydration, loss of disc height, and impaired function. These changes often result in increased pain and mobility limitations. Magnetic Resonance Imaging (MRI), especially at 1.5 Tesla (1.5T), is a key diagnostic tool for assessing LDD in postmenopausal women, providing high-resolution, non-invasive images of the lumbar spine. This review highlights the role of 1.5T MRI in detecting degenerative changes, emphasizing advanced imaging techniques such as T2-weighted imaging, T2 mapping, and diffusion-weighted imaging. These methods improve diagnostic accuracy by revealing subtle changes in disc hydration and structure. The article also discusses how estrogen deficiency accelerates disc degeneration by promoting matrix degradation and inflammation. Additionally, MRI findings such as hypointense T2 signals, Modic changes, and reduced disc height are discussed as important markers in postmenopausal women. These imaging results are crucial for personalized treatment planning. In conclusion, 1.5T MRI is an essential tool for evaluating, monitoring, and managing lumbar disc degeneration in postmenopausal women, aiding in early detection and effective treatment strategies.
Intellectual Property and The Human Biological Material: Navigating Legal Ownership and Rights
The intersection of intellectual property (IP) and the human body presents a dynamic and evolving landscape, raising profound legal, ethical, and societal questions. This article explores the complexities of ownership, acquisition, and control over human body parts and genetic material, offering a multidisciplinary perspective that blends legal theory with real-world implications. It begins by examining traditional concepts of property and how these frameworks apply when the subject matter is the human body. As biotechnological advances redefine what is possible, particularly in genetics, questions of who can own or control biological materials have become increasingly interesting. Genetic ownership is particularly contentious, with significant implications for research, innovation, and individual rights. The article further analyzes the notion of bodily ownership through jurisprudential, constitutional, and cultural lenses. Legal frameworks such as the Bharatiya Nyaya Sanhita and constitutional protections like Article 21 are discussed about bodily autonomy and integrity. The inquiry then extends to whether genetic material should be considered a body part, drawing on global conventions and scholarly debate. Attention is also given to the commoditization of human body parts, ranging from organ trafficking and commercialized healthcare practices to cutting-edge technologies such as regenerative medicine and cyborg integration. The role of intellectual property rights in this context, particularly patents on human biological materials, is examined through landmark legal cases and pharmaceutical industry practices. Concluding with both national and international perspectives, the article offers recommendations for navigating this ethically sensitive and legally intricate terrain in an era of rapid scientific advancement.
Lumbar Pedicle Morphometric Analysis: A Thorough Review
Assessing the size and shape of lumbar vertebral pedicles is important when planning and performing spinal surgeries, especially those involving pedicle screws. Knowing the exact dimensions helps doctors place the screws just right, which makes the spine more stable and reduces chances of problems like screw loosening, pedicle breaches, or injury to nerves and blood vessels. Recent advances in imaging tools, such as measurements taken from dry bones, traditional CT scans, and high-resolution micro-CT scans, have made it easier to gather detailed anatomical data on lumbar pedicles. These studies show that the shape and size of pedicles can vary a lot depending on factors like age, gender, ethnicity, and the specific level of the spine. What's more, using Hounsfield Units (HU) from CT scans has become a useful way to predict bone quality and assess the risk of screw loosening, helping surgeons make better decisions. This review brings together recent research from both Indian and international populations, focusing on pedicle size measurements, how they differ in various regions, and how they change with age. It also identifies anatomical features that may make screw stability more challenging. By reviewing multiple studies, this article aims to emphasize the best methods used in research, summarize key findings, discuss what these mean for clinical practice, and suggest ways to improve pre-surgery planning—eventually making surgeries safer and outcomes better.
“An Ayurvedic Insight into Venous Ulcer Management W.S.R. to Sirajgranthi -A Case report”
Introduction: Venous leg ulcers are chronic wounds that result from prolonged venous insufficiency, primarily affecting older adults. These ulcers develop due to poor blood flow in the veins, leading to tissue breakdown, especially in the lower extremities. Over time, this can cause significant disability and complications. Venous ulcers represent a chronic condition with significant morbidity, often resistant to conventional therapies. Clinical Findings: A female with a 6-month history of a non-healing venous ulcer on lower leg. She had a history of varicose veins and mild hypertension. The ulcer was associated with pain and serous exudate. Intervention: This single-case study explores the therapeutic potential of Nagakesar Ghrit, an Ayurvedic medicated ghee traditionally used for its anti-inflammatory and wound-healing properties, in managing the venous ulcer. Outcome: This study suggests that Nagakesar Ghrit may enhance venous ulcer healing, with a 78.6% reduction in ulcer area in 21 days. These outcomes align with Ayurvedic principles attributing Nagakesar’s efficacy to its antimicrobial and tissue-regenerative properties, potentially augmented by ghee’s emollient and anti-inflammatory effects. Conclusion: This case suggests Nagakesar Ghrit may offer a novel approach to venous ulcer management, though larger studies are needed to validate these findings. Further research is needed to establish standardized treatment protocols and explore the long-term outcomes of various therapeutic interventions.
Coexistence Of Pellagra With Wernicke’s Encephalopathy In An Alcoholic Patient: Case Report And Review Of Literature
We report a case of 30-year-old male chronic alcoholic presented with gait disturbance from last 1 year associated with cognitive impairment along with auditory and visual hallucinations. Intermittently had few episodes of seizures (GTCS). Despite continuous treatment he developed scaly itching skin rashes associated with photosensitivity and marked pain with heightened response to touch. He further worsened as he started hearing abnormal voices, suspiciousness and agitated behavior. Further the ataxia worsened and he also developed bilateral ophthalmoparesis. During hospital stay myoclonus was noticed which was startle in nature. Possibility of alcoholic pellagra encephalopathy (APE) along with Wernicke’s encephalopathy (WE) was kept and treatment was reviewed and adequate nicotinamide with thiamine supplementation was given. Clinical condition improved drastically in 1 week with resolving startle myoclonus along with resolved ophthalmoparesis. Ataxia resolved in the next one month.
Ergonomic Employee Satisfaction and Tourist Experiences: A Review of Indirect Impacts on Tourist Satisfaction in the Hotel Industry.
The importance of employees and their organizational commitment has become increasingly significant for business success in today's fast-paced environment. This is particularly relevant in the service industry, especially in tourism, which faces challenges such as high employee turnover, customer loyalty, and other factors. Employee satisfaction is crucial in fostering organizational commitment, which ultimately improves the quality of services provided. From a tourist’s viewpoint, it is essential to understand how satisfaction with tourism services, delivered by ergonomically content employees, affects their experience. Ergonomics, a modern approach that incorporates advanced technologies, seeks to enhance employee performance and productivity while ensuring a comfortable work environment. This paper will explore how ergonomically satisfied employees contribute to a better tourism experience. The primary focus is on conducting a literature review of employee satisfaction within the context of ergonomics and its impact on tourism experiences in the hotel industry. This study will offer new insights into the indirect impact of ergonomically satisfied employees on tourist satisfaction in hotels. By understanding tourists' perspectives, this research aims to improve the tourism experience and better address the needs of visitors to destinations in India. Ultimately, this research will fill gaps in existing literature and create new opportunities for tourism studies.
Navigating Masculinity: Exploring Coping Strategies And Help-Seeking Attitudes Among Young Adult Men In India
Young adult men in India face significant challenges in addressing mental health issues due to societal expectations, cultural norms, and stigma surrounding emotional expression and help-seeking behaviors. This qualitative study examines the coping strategies and help-seeking attitudes of young adult men in India, focusing on the impact of societal and cultural norms on their mental health behaviors. Through semi-structured interviews with 30 male participants aged 18 to 30, a range of adaptive and maladaptive coping strategies were identified. Adaptive strategies included physical exercise, mindfulness, and social support, while maladaptive behaviors such as substance use and emotional suppression were common. Participants’ reluctance to seek professional help was influenced by stigma, self-reliance, and societal expectations of masculinity. Barriers to accessing mental health services included financial constraints, lack of awareness, and cultural beliefs surrounding mental health. These findings stress the need for improved mental health awareness, accessible resources, and the challenging of societal norms that deter young men from seeking professional support. The study calls for culturally sensitive interventions to promote healthier coping and help-seeking behaviors among young adult men in India.
The Impact of Globalization on Hotel Management Practices
This dissertation examines the profound impact of globalization on hotel management practices, focusing on the challenges of adapting to diverse cultural, economic, and technological changes that influence service delivery and operational efficiency. Utilizing a mixed-methods approach, data were collected through surveys and interviews with industry professionals, complemented by a comprehensive analysis of hotel performance metrics across various regions. The findings reveal that successful hotel management increasingly relies on cultural sensitivity, technological integration, and innovative service delivery methods to enhance customer satisfaction and operational productivity in a globalized market. Notably, the research highlights that hotels that embrace these strategies experience significantly improved performance indicators, such as occupancy rates and customer loyalty. The significance of these findings extends beyond the hospitality industry, suggesting that the principles of adaptability and responsiveness to global trends are crucial for success across various sectors, including healthcare, where similar challenges of managing diverse clientele and efficient service delivery manifest. Consequently, this study provides critical insights for practitioners and policymakers, emphasizing the need for strategic frameworks that enable organizations to navigate the complexities of globalization effectively, thereby fostering resilience and competitiveness in an increasingly interconnected world.
“Impact Of Mobility On Participation Restriction In Individuals With Spinal Cord Injury”
Background And Objective: Traumatic Spinal Cord Injury is considered as a major disability and also life threatening condition that carries a high risk of morbidity and mortality also face challenge in the in social participation once they enter the community due to which quality of life of an individual with SCI is affected. It is essential to understand how people with SCI live with the overall physical, social and attitudinal environment in which they experience their day-to-day lives and many factors acts either as barrier or facilitator to the person with SCI. Mobility whether independent or supported by assistive devices is a vital aspect of functional autonomy and plays a key role in enabling individuals to participate in society. (1) Therefore, this study aimed to identify the factors influencing mobility related participation restrictions in individuals with spinal cord injury. Study Design: A cross sectional study. Materials and Methods: Details of patients with traumatic spinal cord injury were collected from KLE Hubli co-operative hospital, Rehab centers in and around Hubballi, Karnataka and a total of 30 individuals were interviewed face-to-face using the CHART-SF questionnaire, administered in the local vernacular language. Responses were recorded and scored according to the CHART-SF manual guidelines. Results: Descriptive analysis was used for finding mean, median an standard deviation and the median scores for the CHART-SF Mobility domain was 14 severe handicap, All statistics were done with SPSS version 26.0. A probability value of p ≤ 0.05 was considered to indicate a significant difference. Conclusion: Thus, there is a strong need to focus on planning the better rehabilitation and awareness programs for the betterment of quality of life of people with SCI highlighting on major aspects/factors affected under domain mobility, in and around Huballi.
Depression Detection In Social Media User Using Deep Learning
Depression is a very severe and grave mental disorder, which is affecting most of the population nowadays because of various reasons like stress at work, school, college, personal life, other diseases, etc. It is also called as Major depressive disorder. Depression is a significant mental health concern that affects a vast number of individuals worldwide. With the rise of social media, people often express their emotions and struggles through online platforms, providing an opportunity for early depression detection using advanced computational techniques. This project proposes a deep learning-based approach using Long Short-Term Memory (LSTM) networks to analyze user-generated content and identify depressive tendencies. The system is designed to classify words related to depression in social media posts and provide automated motivational responses to users. The proposed system enhances mental health support by generating link-based alerts for the user's most interacted social media friends when severe depressive content is detected. This feature ensures timely awareness and potential intervention from close contacts, offering a supportive network for individuals at risk. By integrating LSTM-based classification with real-time monitoring and social connectivity, this project aims to provide a scalable and non-intrusive method for depression detection and mental health awareness in the digital age.
A Scanning Electron Microscopy Study of The Renal Glomeruli and Tubules in Adult Albino Rats Following Oral Administration of Sodium Fluoride, And the Possible Protective and Curative Role of Plant Leaf Extract Boerhaavia Diffusa L
This study used microdissection methods, such as scanning electron microscopy, to clarify the morphological alterations in the kidneys of albino rats treated with sodium fluoride. Eight groups of six rats each were randomly selected from a total of forty-eight animals. Rats in Control I were given deionized water orally. For 40 days, rats in the first and second groups received daily doses of 300 and 600 mg NaF/kg bw, respectively. For 20 days, 500 mg/kg b.w./day of Boerhaavia diffusa L. leaf extract was given orally to Control II rats. After receiving a 20-day pretreatment of 500 mg/kg bw/day of Boerhaavia diffusa L. leaf extract, groups third and fourth were subjected to 40 days of exposure to 300 and 600 mg NaF/kg bw/ /day. Groups fifth and sixth were exposed firstly to 300 and 600 mg NaF/ kg bw /day and then post-treated with leaf extract of Boerhaavia diffusa L. for 20 days. Scanning electron microscopy was used to examine the morphological characteristics of the rat kidneys treated with sodium fluoride. The features included the shortening of the podocyte processes, cytoplasmic blebs, hypertrophy, atrophy, knob-like projections at the end of the podocytes, shrinkage of the cell body, extreme deprivation of erythrocytes, and collagen fibers. It might be said that sodium fluoride negatively impacted the kidney's morphological structure. The renal damage changes may be lessened by administering Boerhaavia diffusa L. leaf extract both before and after treatment.