Greenfort International Journal of Applied Medical Science
Greenfort International Journal of Applied Medical Science Peer-Reviewed • Open Access • Bimonthly ISSN (Online): 2584-2420 | ISSN (Print): 3048-6904 DOI Prefix: 10.62046/gijams | Published by Greenfort International Publisher, India ABOUT THE JOURNAL The Greenfort International Journal of Applied Medical Science is an international, peer-reviewed, open-access journal dedicated to publishing high-quality research in biomedical and applied medical sciences. The journal provides a platform for clinicians, researchers, academicians, and healthcare professionals to disseminate original research, clinical studies, reviews, case reports, and short communications that contribute to evidence-based practice and improvements in public health. AIMS & SCOPE The journal focuses on original research and evidence-based clinical studies in biomedical and applied medical sciences, prioritizing rigorous methodology, ethical research practices, reproducibility, and translational relevance that advance medical knowledge, support evidence-based clinical practice, and improve patient and public health outcomes. Research topics include, but are not limited to: Clinical medicine and therapeutic studies Public health and epidemiology Translational and biomedical sciences Diagnostics and healthcare systems Allied health disciplines and rehabilitation sciences PUBLICATION TYPES The Journal publishes the following article types: ✔ Original Research Articles ✔ Review Articles ✔ Case Reports ✔ Short Communications ✔ Brief Reports ✔ Letters to the Editor PEER REVIEW & ETHICS All manuscripts undergo editorial screening followed by rigorous peer review. Editorial decisions are based solely on scientific merit, originality, ethical integrity, and relevance to the journal’s scope. This Journal adheres to internationally recognized publication ethics standards including COPE, ICMJE, and WAME guidelines. Authors must ensure that submissions are original and free from plagiarism and research misconduct. OPEN ACCESS POLICY This Journal is fully open access. All content is freely available immediately upon publication under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, allowing wide sharing and reuse for non-commercial purposes with appropriate credit. ARCHIVING & PRESERVATION Published content is preserved through trusted digital repositories and assigned permanent DOIs to ensure long-term accessibility. EDITORIAL BOARD Led by internationally experienced researchers and clinicians, the editorial board represents diverse medical and health sciences fields, ensuring robust peer review and academic leadership. CURRENT ISSUE & ARCHIVES Explore the latest published research and access previous issues with full-text PDFs. SUBMISSION & AUTHOR GUIDELINES Prospective authors can submit manuscripts through the online submission system. Detailed author instructions, policy statements, and manuscript preparation guidelines are available on the website.
The Greenfort International Journal of Applied Medical Science is published under the Creative Commons Attribution Non-Commercial 4.0 International (CC BY-NC 4.0) license. This license permits any non-commercial use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as appropriate credit is given to the original author(s) and the source. https://creativecommons.org/licenses/by-nc/4.0/deed.en
Students’ Perception On ‘Peer Assisted Learning’ In Designing of Poster & Charts in the Department Of Anatomy – A Qualitative Analysis.
Background: Poster presentation is an interactive and experiential learning tool that encourages curiosity, creativity, and conceptual integration. In Anatomy—a complex and content-heavy subject—such student-centered approaches can enhance engagement and facilitate deeper understanding through visualization and peer interaction.Objective: To introduce poster presentation as a peer-assisted, student-led learning strategy in Anatomy and to explore students’ perceptions regarding its effectiveness in promoting active, collaborative, and self-directed learning.Material & methods: A qualitative, quasi-experimental educational study was conducted in the Department of Anatomy, Barasat Government Medical College. Ninety-eight first-year MBBS students participated voluntarily and were divided into ten groups, each assigned a specific topic in gross anatomy through a lottery-based selection process. Three members from each group presented posters, while the rest participated in designing, peer discussions and evaluations. Data were collected using unstructured feedback questionnaires. Responses were thematically analysed to identify common perceptions and learning outcomes.Observations: Students perceived the poster presentation activity as highly effective in promoting active participation and deeper learning. It encouraged exploration of multiple resources, enhanced conceptual clarity, and improved communication and teamwork skills. The activity also fostered creativity and critical thinking, transforming passive learning into an engaging experience. Although a few participants cited time constraints and initial hesitation, the majority found the activity enjoyable, interactive, and beneficial for both academic and personal growth.Conclusions: Poster presentation proved to be an effective peer-assisted, student-centered learning strategy in Anatomy. Its integration into the undergraduate medical curriculum can enhance comprehension, retention, and collaborative learning while nurturing essential skills such as critical thinking and communication.
Poster Presentation, Peer Assisted Learning, Critical thinking, Collaborative learning, Self-Directed Learning, Anatomy.
Copyright (c) 2026 Bhumika Bhawna, Dona Saha, Gopal Chandra Mondal (Author) https://creativecommons.org/licenses/by-nc/4.0
Comparison of Computed Tomography Findings and Intraoperative Correlation in Adult Patients Presenting with Symptoms of Intestinal Obstruction
Background: Intestinal obstruction is a common surgical emergency, accounting for approximately 15% of all emergency department visits for abdominal pain and around 20% of the total volume of emergency surgical procedures. Multi-detector computed tomography (Multi-Detector Computed Tomography, MDCT) is the preferred first-line assessment method for this condition. The present study adopts intraoperative outcomes as the gold standard to evaluate the diagnostic accuracy of this modality for intestinal obstruction. Objective: To evaluate the diagnostic accuracy of MDCT in intestinal obstruction, using intraoperative findings as the reference standard. Methodology: This is an observational study of patients undergoing intestinal obstruction surgery, conducted at FAAMCH in Bapeeta, Assam. The 12-month study enrolled 40 confirmed patients aged 18 to 70 years. All participants received plain and contrast-enhanced MDCT scans performed with a Philips MX16-slice scanner, and imaging results were compared with findings from intraoperative exploration. Results: The most common age group affected was 46–60 years (40%), with a male predominance (62.5%). Small bowel obstruction was present in 77.5% of cases. The leading etiology was adhesion/bands (30%), followed by hernia (17.5%) and neoplasm (15%). MDCT correlated with intraoperative findings in 36 of 40 patients (90%). Sensitivity was 94.7%, specificity 100%, PPV 100%, NPV 50%, and accuracy 95%. Conclusion: MDCT demonstrates high diagnostic accuracy for intestinal obstruction and serves as an indispensable preoperative tool guiding surgical decision-making. Its ability to identify the site, cause, and complications of obstruction positions it as the imaging modality of choice in emergency abdominal settings.
Intestinal obstruction; MDCT; Computed tomography; Intraoperative correlation; Small bowel obstruction
Copyright (c) 2026 Dr Dildar Rezzak, Dr. Sangeeta Nath, Dr Horish Rabha, Dr Madhurjya Kumar Thakur (Author) https://creativecommons.org/licenses/by-nc/4.0
Unmasking Bioflim- producing Gram Positive Cocci in Post-Operative Wound Infections
Introduction-The third most frequent nosocomial infection to be documented is surgical site infection. They are responsible for the rising expense, morbidity, and death rates associated with surgery. The risk of surgical site infections has ranged from 2.5% to 41.9%. Staphylococcus aureus are common from wound infections during surgery, which might act as stimulants for the development of systemic infections. Objectives-The objective of this study was to isolate and identify various Gram positive cocci from surgical site infected cases and detect their antimicrobial susceptibility pattern along with their capability of biofilm production. Materials and Methods- A total of 166 culture positive gram-positive cocci were isolated from infected surgical sites. Standard procedure and protocol were followed for identification of isolates. Antimicrobial susceptibility testing was done by Kirby Bauer disc diffusion method as per current CLSI guidelines. Methicillin resistance in staphylococcus isolates was tested by cefoxitin disc diffusion method. Biofilm formation detection done by Congo red and tube method. Results- Out of 166 Gram positive cocci, 112 were S. aureus and 54 were Enterococci. S. aureus isolates showed highest percentage resistance to penicillin (95.53) and erythromycin (59.82%). Methicillin resistance was found to be 43.75 %. Enterococci isolates (including Enterococci spp. and Enterococcus faecalis) showed highest percentage resistance to penicillin (98.14%) followed by ampicillin (88.88%). Among the 112 isolates of S. aureus, a significant majority, 84 isolates (75%), were found to be biofilm producers, in contrast, of the 54 isolates of Enterococcus spp., 30 isolates (55.5%) were biofilm producers. This indicates that a higher proportion of S. aureus isolates are capable of producing biofilms compared to Enterococcus spp.
Surgical site infection, Methicillin resistant Staphylococcus aureus, Enterococcus, Biofilm formation.
Copyright (c) 2026 Dr.Mrunal.M.Patwardhan, Dr. Pankaj joshi, Dr.Aditya Chaturvedi, Dr.Neeta jangale (Author) https://creativecommons.org/licenses/by-nc/4.0
Assessment of Maternal and Neonatal Oxidative Stress and Antioxidant Defence during Caesarean section
Background: Pregnancy is a physiological state in which there is an increased redox imbalance in utero. Foetal oxygenation is fully dependent upon integrity of uteroplacental circulation. Hypoxia is one of the main factor which induces free radical generation in the perinatal period. Studies have shown there is an increase in malondialdehyde (MDA) level, a marker of oxidative stress in vaginal delivery than elective caesarean section Hence the present study was aimed at quantifying the changes with respect to oxidative stress as well as antioxidant status for both mother and newborn during delivery by a caesarean section.Methods. Uncomplicated term pregnant women who delivered either by elective or emergency lower segment caesarean section (n=20) were included in the study. Plasma malondialdehyde (MDA) for lipid peroxidation (LPO) and other antioxidant enzymes such as Superoxide dismutase (SOD), Glutathione Peroxidase (GPx) and total reduced Glutathione (GSH) were estimated in plasma and hemolysate respectively using the spectrophotometric method. Results were analysed by Student ‘t’ test taking p<0.05 as statistically significant.Results: LPO was significantly higher in cord blood when compared to both before (p<0.05) & after delivery (p<0.05) samples. GSH was found to be higher in maternal blood before delivery than after delivery (p<0.001) and cord (p<0.01) blood samples. GPx & SOD did not reach any statistical significance. But GPx in cord blood sample showed significant negative correlation with maternal age in LSCS (r=-.445, p<.05)Conclusion. Pregnancy results in oxidative stress which is further aggravated during delivery by caesarean section and predisposes the neonate to increased oxidative stress when compared to maternal system which is reflected as an alteration in their antioxidant enzyme levels.
free radicals, oxidative stress, lower segment caesarean section, maternal antioxidant defence.
Copyright (c) 2026 Paramita Bhattacharyya, Mathangi DC, Pricilla Johnson (Author) https://creativecommons.org/licenses/by-nc/4.0
Awareness Regarding Global Warming and knowledge towards climate change among medical students of Shyam Shah Medical College Rewa.
Background- Global warming is the gradual increase in the average temperature of the Earth's atmosphere and oceans. Climate change and environmental degradation have far-reaching consequences for present and future generations. They pose serious threats to human well-being, economic stability, and ecosystem health. Because of the seriousness of these concerns, global programs are being started to mitigate climate change, prepare for its consequences, and promote sustainable development alternatives. Aim & Objective- 1) To assess the awareness regarding global warming and its health hazards among the medical students 2) To assess the knowledge and attitude towards climate change among medical students of Shyam shah medical college, Rewa, Madhya Pradesh. Material and method- A Cross-sectional study was conducted. A self-administered, online questionnaire was used to collect data from 300 UG medical students of Shyam shah medical College Rewa. The collected data was analysed using SPSS 20 and MS Excel to draw results. Result- It was found that 96% of students were aware of climate change. While 95% students believe that human behaviours are responsible for climate change. 75.8% of the students were aware about greenhouse gases. 78% of students emphasize health-related aspects of climate change preventive measures. According to 62.5% students, direct physical hazards of extreme climatic events are most important health-related impact of climate change. Majority have commented that urbanization contribute most to climate change. Conclusion-Although most students are aware of global warming, there is still scope for advancement of mitigation efforts. A nationwide poll is advised to raise awareness about the health risks of global warming. A cross-sectional investigation on climate change and related health risks is recommended to assess medical students’ preparation and suggest curricular adjustments.
Copyright (c) 2026 Dr. Ratan Priya Gupta, Dr Anshuman Sharma, Dr. Neera Marathe, Dr. Amiy Krishna Gupta, Dr. Satendra Gupta, Dr. Bhavna Tomar (Author) https://creativecommons.org/licenses/by-nc/4.0
Correlation Between Chronic Stress Levels Among Undergraduate Medical Students with Tea/Coffee Consumption and Its Impact on Academic Performance
Medical education is widely recognized as a highly demanding and stressful academic discipline. Undergraduate medical students frequently encounter multiple stressors including extensive academic workload, frequent examinations, clinical responsibilities, lack of sleep, and adjustment to a competitive learning environment. Persistent exposure to these stressors may adversely affect students' mental health and academic performance. Previous studies have reported that stress is highly prevalent among medical students and may contribute to various behavioral adaptations and lifestyle changes.Tea and coffee are among the most commonly consumed caffeinated beverages worldwide, particularly among students. Caffeine consumption is often used as a strategy to combat fatigue, improve alertness, and enhance concentration during periods of academic stress. However, excessive consumption may be associated with anxiety, sleep disturbances, increased stress perception, and impaired academic functioning. Several studies have suggested that students experiencing higher levels of stress tend to consume greater quantities of caffeinated beverages. While moderate caffeine intake may temporarily improve cognitive performance, chronic excessive consumption may adversely affect sleep quality and psychological well-being, thereby influencing academic achievement. Understanding the relationship between stress, tea/coffee consumption, and academic performance is important for developing effective student wellness programs. Therefore, the present study aimed to assess the correlation between chronic stress levels among undergraduate medical students and tea/coffee consumption and to evaluate their impact on academic performance.
Lifestyle changes, tea and coffee, stress, sleep, academic workload, Medical education
Copyright (c) 2026 Dr Bhavna Tomar, Dr Shubhangi Nayak, Dr Anshuman Sharma, Dr Himanshi Yadav, Dr. Ratan Priya Gupta (Author) https://creativecommons.org/licenses/by-nc/4.0
Variation in Platelet Count and Platelet Indices with Their Clinical Correlation in Neonatal Sepsis
Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality. Early diagnosis remains challenging because clinical manifestations are often nonspecific and conventional diagnostic methods such as blood culture are time-consuming. Platelet count and platelet indices have emerged as potential adjunctive biomarkers for diagnosis and prognosis in neonatal sepsis. Aim: To evaluate variations in platelet count, mean platelet volume (MPV), and platelet distribution width (PDW) and determine their clinical correlation in neonatal sepsis. Methodology: A hospital-based observational cross-sectional study was conducted among 100 neonates (0–28 days) with suspected sepsis admitted to the neonatal unit of Dr. B.C. Roy PGIPS, Kolkata, from February 2021 to October 2022. Complete blood count, platelet indices, sepsis screen, and blood culture were performed. Platelet count <1.5 lakh/cumm, MPV >10.8 fL, and PDW >13% were considered abnormal. Diagnostic performance and prognostic significance were analyzed using appropriate statistical tests and ROC curve analysis. Results: Among 100 neonates, 55% were culture-positive and 56% had late-onset sepsis. Thrombocytopenia was present in 97% of cases, while elevated MPV and PDW were observed in 57.35% and 58.82% respectively. Severe thrombocytopenia was significantly associated with mortality (77.78%, p<0.0001). Expired neonates had significantly lower platelet counts and higher MPV and PDW values than survivors (p<0.001). For predicting mortality, MPV >12.1 fL demonstrated 84.21% sensitivity and 91.84% specificity (AUC=0.913), while PDW >15.3% showed 84.21% sensitivity and 87.76% specificity (AUC=0.908). MPV emerged as the best predictor of mortality. Conclusion: Thrombocytopenia, elevated MPV, and increased PDW are significantly associated with neonatal sepsis and adverse outcomes. These inexpensive and readily available platelet parameters may serve as useful adjunctive diagnostic and prognostic markers in neonatal sepsis, particularly in resource-limited settings.
Neonatal sepsis, Thrombocytopenia, Platelet count, Mean platelet volume, Platelet distribution width, Mortality, Biomarkers, Neonate
Copyright (c) 2026 Dr. Sneha Das, Dr. Aritra Kapat, Dr. Piu Das, Dr. Koushik Biswas, Dr. Subhalakshmi Mukhopadhyay (Author) https://creativecommons.org/licenses/by-nc/4.0
A Comparative Study of Haemodynamic Response During Endotracheal Intubation Between Injection Dexmeditomedine Versus Combination of Paracetamol+Tramadol+ Lignocaine+ Magnesium Sulphate in Patients Undergoing Abdominal Laparoscopic Surgeries
Background:Direct laryngoscopy and tracheal intubation frequently provoke sympathetic surge that can destabilize cardiovascular parameters. Several pharmacologic agents are used to blunt this stress response and improve perioperative analgesia. Dexmedetomidine, a selective α₂-agonist, provides predictable hemodynamic control as well as analgesia, whereas a practical multimodal mixture containing paracetamol, tramadol, lignocaine, and magnesium sulfate (“Shivmix”) is often employed in resource-limited environments. This research assessed comparative effectiveness of dexmedetomidine and this multimodal combination in patients undergoing elective laparoscopic abdominal procedures.Methods:In total, 120 adults between ages of 18-50, who have been scheduled for an elective laparoscopic cholecystectomy and classified as ASA I–II were divided into 2 groups of 60 each for this prospective, randomized, double-blind research. Group B received an infusion of paracetamol 20mg/kg, tramadol 2mg/kg, lignocaine 1.5mg/kg, and magnesium sulfate 40mg/kg in 100 mL saline for the same duration as Group A, which received intravenous dexmedetomidine 1μg/kg over ten minutes. Infusions were both finished 15 minutes before laryngoscopy. All patients had the same anesthetic technique. Hemodynamic variables were monitored at preset intervals, and pain has been assessed by using the VAS scale for 24 hours post-surgery.Results:Groups' baseline characteristics were similar. There was no difference between the groups, and neither regimen caused an increase in HR during intubation. Systolic and diastolic blood pressure increases during and after intubation were more effectively prevented by dexmedetomidine (P<0.05). In contrast, the combination of multimodal was consistently associated with lower postoperative VAS scores at the majority of time points and significantly lower rates of rescue analgesia (30% vs 63%, P<0.05). Dexmedetomidine group experienced transient bradycardia only. Other adverse effects have been comparable and minimal.Conclusion:Dexmedetomidine has been more effective in suppressing the pressor response to intubation, and multimodal infusion “Shivmix” was more effective and maintained postoperative analgesia. The multimodal approach is a viable alternative when access to opioids and/or dexmedetomidine is limited. Selection of therapy may thus be influenced by the clinical need for immediate haemodynamic control or for long-term analgesia.
Magnesium sulphate, hemodynamic response, tramadol, lignocaine, dexmedetomidine, tracheal intubation, paracetamol
Copyright (c) 2026 Dr. Indhumathi P. S, Dr. Apurva Agarwal, Dr. Neetu Singh, Dr. Satyendra Gahlot, Dr. Ashish Puri, Dr. Shivam Rai (Author) https://creativecommons.org/licenses/by-nc/4.0
Rethinking flipped classroom in forensic medicine: a content-sensitive approach to self-directed learning in CBME
Introduction: Competency-Based Medical Education (CBME) emphasises the development of the Indian Medical Graduate as a lifelong learner too which can be achieved by Self-directed learning (SDL) explicitly allocated dedicated curricular time. However, SDL is often misinterpreted as unguided self-study, with limited clarity regarding its structured implementation. If SDL is intended to foster lifelong learning, the role of the teacher, assessment strategies, and topic selection become critical. Evidence remains limited on when, how, and for which types of content SDL approaches are most effective. Flipped classroom is one of the ways to achieve the goal of conducting SDL in undergraduate medical education.Objective: To compare the learning outcomes, to assess the knowledge retention between flipped classroom and conventional lecture methods, and to explore undergraduate students’ perceptions of flipped classroom as an approach to facilitate self-directed learning in Forensic MedicineMethods: A comparative teaching intervention was conducted among undergraduate medical students, with the same instructor delivering selected topics using conventional lectures and flipped classroom methods. The flipped model utilised curated learning resources provided prior to class. During the dedicated SDL hours for flipped classroom batches the pre-learned contents were discussed and clarified. Learning outcomes were assessed using recall-based MCQs and learner perceptions were collected at the end of each session.Results: The flipped classroom approach demonstrated improved knowledge retention and was positively perceived by students compared to conventional lectures like other studies have showed. However, its effectiveness appeared to be content-dependent in this study. While flipped classroom was advantageous for standalone and conceptually accessible topics, conventional lectures performed better for recall-intensive and medico-legal content. In addition, conducting SDL through the flipped model requires substantial faculty preparation and may be less suitable for some topics. These findings support a selective and context-sensitive integration of SDL though flipped classroom within CBME rather than its uniform application.Conclusion: SDL should not be equated with independent learning in isolation; rather, dedicated SDL time implies structured guidance, accountability, and assessment. The effectiveness of SDL through flipped classroom appears to be content-dependent. These findings highlight that lifelong learning must be actively cultivated through appropriate instructional design and integration aligning more closely with CBME goals rather than assumed.
Flipped classroom, Self-directed Learning, Lifelong learner, Medical Education, Indian Medical Graduate, Forensic Medicine.
Copyright (c) 2026 Bharath Shetty, Sruthi Rai P, Navya BN, Neelambikai Natarajan (Author) https://creativecommons.org/licenses/by-nc/4.0
Awareness, Attitudes, and Practices Related to Cosmetovigilance Among Medical Interns and Postgraduates at a Tertiary Care Teaching Hospital
Background: Cosmetovigilance plays a crucial role in identifying, reporting, and preventing adverse events related to cosmetic products. However, awareness and practice of cosmetovigilance among healthcare professionals remain inadequately explored. Objectives: To assess and compare the knowledge, attitude, and practice (KAP) related to cosmetovigilance among interns and postgraduate students at a tertiary care teaching hospital. Methods: A prospective cross-sectional study was conducted from August to October 2025 at a tertiary care hospital. A total of 245 participants, comprising interns and postgraduate students aged 22 years and above, were enrolled after obtaining written informed consent. Data were collected using a structured questionnaire assessing knowledge, attitude, and practice related to cosmetovigilance. Associations between participant groups and KAP parameters were analyzed using the Chi-square test. Results: Interns demonstrated significantly higher knowledge regarding key aspects of cosmetovigilance, including awareness of cosmetic-related adverse effects, reporting mechanisms, headquarters of cosmetovigilance, and causality assessment methods (P < 0.05). Attitudes towards cosmetovigilance were largely comparable between the two groups, except for a significant difference regarding mandatory reporting of cosmetic-induced adverse events. Actual practice of cosmetovigilance was limited and similar among both groups; however, interns showed significantly greater interest in attending training and workshops related to cosmetovigilance (P < 0.05). Conclusion: The study highlights gaps in cosmetovigilance knowledge and practice among interns and postgraduate students, despite generally positive attitudes. Strengthening training programs and incorporating structured sensitization on cosmetovigilance may improve reporting practices and enhance patient safety.
Cosmetovigilance, Pharmacovigilance, KAP, cosmetic products, attitude
Copyright (c) 2026 Akash Sinha, Pradnya Deolekar, Kavitha Dongerkery, Atharva Dahibhate, Prateek DT, Shubham Sagar, Srirambabu V, Maulik Chandibhamar, Safaa Mohammed Shahid, Arjun Ananthanarayan, Veena Rane (Author) https://creativecommons.org/licenses/by-nc/4.0
Assessing the economic value of oral antifungals: A comparison of branded and generic options in India
Introduction: India's pharmaceutical market is characterized by a significant presence of both generic and branded drugs, particularly for common ailments like fungal infections, which pose a substantial public health and economic burden. In tropical countries like India, superficial fungal infections are quite common, and frequent relapses after treatment have increased the need for long-term therapy, significantly increasing the cost of treatment, so the treatment of fungal infections can raise the economic burden on the patient. Given the high variability in drug pricing and the imperative for cost-effective healthcare, a pharmacoeconomic analysis comparing generic and branded oral antifungals in India is crucial to inform prescribing practices and optimize resource allocation. Methods: The cost of different brands of commonly used oral antifungals was sorted out by referring latest “Current Index of Medical Specialties” February- April 2025, and 1mg online pharmacy and the Janaushadhi website. The cost of 10 dosage forms (Tablets/capsules) in INR of each brand, Cost Ratio, and Percentage Cost Variation for individual drug brands was calculated. At last, the cost ratio and percentage cost variation of various brands were compared with generic drugs. Results: The data analysis showed a significant variation in the costs of different brands of oral antifungals in the Indian market. Percentage variation in cost for oral preparations of proton pump inhibitors marketed in India was found to be griseofulvin 500mg (886.2%), ketoconazole 200mg (3214.2%), fluconazole 200mg (1763%), itraconazole 200mg (38438%), terbinafine 250mg (3789.6%), posaconazole 100mg (8772.8%), voriconazole 200mg (8335.2%) and clotrimazole 100mg (856.9%). Conclusion: There is a wide variation in the prices of oral antifungals available in the market. Regulatory authorities, pharma companies, and physicians should maximize their efforts to reduce the cost of drugs. There is a need for strict actions for cost policy regulation and sensitization of doctors for the selection of appropriate drugs.
Oral antifungals; Pharmacoeconomics; Cost variation; Branded drugs; Generic drugs; Cost analysis.
Copyright (c) 2026 Prateek D.T., Naaysha Mehta, Shubham Sagar, Srirambabu V, Maulik Chandibhamar, Akash Sinha, Atharva Dahibhate, Pradnya Deolekar, Kavitha Dongerkery, Safaa Mohemmad Shahid (Author) https://creativecommons.org/licenses/by-nc/4.0
CORRELATION OF MITRAL E- POINT SEPTAL SEPARATION WITH LEFT VENTRICULAR EJECTION FRACTION IN PATIENTS OF ACUTE CORONARY SYNDROME
Background: Acute Coronary Syndrome (ACS) is a major cause of morbidity and mortality worldwide and requires rapid assessment of left ventricular (LV) function for risk stratification. Left Ventricular Ejection Fraction (LVEF) is a key prognostic indicator but may not always be quickly measurable in emergency settings. E-point septal separation (EPSS), a simple M-mode echocardiographic parameter, has emerged as a rapid bedside surrogate for assessing LV systolic function.Aim: To determine the correlation between mitral E-point septal separation (EPSS) and left ventricular ejection fraction (LVEF) in patients with ACS.Methods: This observational study was conducted on 100 patients diagnosed with ACS at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, between July 2024 and January 2026. EPSS was measured using M-mode echocardiography in the parasternal long-axis view, and LVEF was assessed using standard echocardiographic methods. Statistical analysis was performed to evaluate the correlation between EPSS and LVEF.Results: The majority of patients were males (71%) and aged 61–80 years (49%). STEMI was the most common presentation (48%). EPSS >7 mm was observed in 84% of patients. Most patients had moderately reduced LVEF (51%). A statistically significant inverse correlation was found between EPSS and LVEF (r = −0.602, p < 0.001), indicating that higher EPSS values are associated with lower LVEF. Additionally, EPSS showed significant association with BNP levels (p = 0.0477), reflecting its utility in assessing cardiac dysfunction.Conclusion: EPSS is a simple, rapid, and reliable bedside echocardiographic parameter that correlates significantly with LVEF in ACS patients. It can serve as a useful screening tool for early identification of LV systolic dysfunction, especially in emergency settings where quick decision-making is essential.
Acute Coronary Syndrome, E-point Septal Separation, Left Ventricular Ejection Fraction, Echocardiography, LV Dysfunction
Copyright (c) 2026 Arpanbir Kaur, Avtar Singh Dhanju, Gaurav Mohan (Author) https://creativecommons.org/licenses/by-nc/4.0
Study of Ki-67 and E-Cadherin Expression in Cervical Cancer as Marker of Proliferation and Invasiveness
Introduction: Cervical carcinoma is one of the most frequent cancers in women all over the world, especially in the developing countries. Increased cell proliferation and decreased cell adhesion are implicated in tumor development. Ki-67 is a well-known cellular proliferation marker and E-cadherin is an important cell adhesion protein related to tumor invasion and metastasis. Aims: The aim of this study was to evaluate the expression of Ki-67 and E-cadherin in cervical cancer for assessment of tumor growth and invasion and to find out their correlation. Also their association with histopathological grade and stage, detection of cervical cancer patients and use of these biomarkers as a sign of proliferation and invasion are also discussed. Materials and methods: The present study was a descriptive cross-sectional observational study. The study was conducted in Department of Pathology, N.R.S. Medical College and Hospital, Kolkata, Sealdah, Raja Bazar, Kolkata, West Bengal 700014 for a period of 18 months. The study population consisted of 62 individuals. Result: High Ki-67 expression was significantly associated with poorly differentiated tumors and advanced FIGO stage (p = 0.001 and p = 0.002, respectively). E-cadherin expression significantly decreased with increasing tumor grade and stage (p = 0.003 and p = 0.001 respectively). A statistically significant inverse association was observed between Ki-67 and E-cadherin expression (p = 0.0001) suggesting that increased proliferation is associated with decreased cell adhesion and increased invasiveness.Conclusion: Ki-67 and E-cadherin are important markers for assessing tumor behavior in cervical cancer. Their combined evaluation could provide valuable prognostic information and assist the identification of aggressive tumors.
Cervical carcinoma, Ki-67, E-cadherin, proliferation, invasion, immunohistochemistry, prognostic markers.
Copyright (c) 2026 Purnendu Ranjit, Soumitra Halder, Dona Saha (Author) https://creativecommons.org/licenses/by-nc/4.0
COMPULSIVE INTERNET USE AMONG UNDERGRADUATE MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY FROM A NORTH INDIAN TERTIARY CARE INSTITUTION
Background: Compulsive Internet Use (CIU), commonly referred to as internet addiction, is a growing behavioural problem that adversely affects psychological health, academic performance, and social relationships. With increasing dependence on digital technology, medical students represent a high-risk group for developing CIU. Aim: To determine the prevalence of compulsive internet use among undergraduate medical students and to assess its correlation with demographic and social factors. Settings and Design: An analytical cross-sectional study was conducted among undergraduate medical students of a medical college in Srinagar, Kashmir, India. Methods and Materials: A total of 281 students who had been using the internet for at least three months were included. Data were collected using a pre-tested, validated questionnaire comprising sociodemographic variables and Young’s Internet Addiction Test (IAT). Statistical Analysis Used: Data were analysed using SPSS software. Descriptive statistics, proportions, and Chi-square tests were applied, and a p-value of <0.05 was considered statistically significant. Results: Of 281 participants, 66% demonstrated internet addiction, with 43% showing mild and 23% moderate addiction. Gender, year of study, place of stay, socioeconomic class, parental education, duration of internet use, money spent, and purpose of internet use showed statistically significant associations with CIU (p < 0.05). Mobile phones were the primary device used (98%), and addicted students spent 6.5–7.2 hours online daily. Conclusions: A high prevalence of compulsive internet use was observed among medical students. Targeted interventions, including digital literacy, counselling, and awareness programs, are essential to promote balanced and healthy internet habits.
Copyright (c) 2026 Dr Sana Rafiq Khuroo, Yasmeen Jan, Dr Heena Nazir, Dr Ashfaq Ahmad Bhat, Dr. Abdul Majid, Dr Jaspinder Pratap Singh Singh, Abid Manzoor (Author) https://creativecommons.org/licenses/by-nc/4.0
Bilateral Accessory long and Short Heads of Biceps Brachii-A Case Report
Introduction: The biceps brachii muscle is a prominent fusiform muscle located in the anteriorcompartment of the arm. Anatomic variations in bicep brachii particularly the presence ofsupernumerary heads are the most frequently observed variation. Method: The upper limbs of an embalmed old male cadaver were dissected for undergraduatemedical teaching in the Department of Anatomy, Punjab Institute of Medical Sciences, Jalandhar. Result: During dissection, bilateral Accessory long and short heads of bicep brachii were observed. These heads had nerve supply and blood supply from branches of musculocutaneousnerve and brachial artery respectively. Conclusion: The presence of accessory heads may confer a mechanical advantage byincreasing the strength of elbow flexion and forearm supination on one side but on other sidesuch variations may contribute to shoulder pain either independently or in association with other pathologies.
Bicep brachii, Accessory heads, Supernumerary heads, Supraglenoid tubercle, Coracoid Process
Copyright (c) 2026 Mamta Sharma , Urvi Prashar, Harpreet Singh Gulati, Kamaljeet Kaur, Jasveen Kaur, Ambica Wadhwa, Sherry Sharma, Anureet Mitra (Author) https://creativecommons.org/licenses/by-nc/4.0
A Study On Variations In The Branching Pattern Of Axillary Artery in North Indian population
Introduction - Axillary artery, a continuation of subclavian artery, is the main (axis) artery to the upper limb. Normally it gives rise to six named branches before continuing as brachial artery. Variability in the origin of certain branches of the axillary artery is frequently apparent but not uniformly studied. The objective of this study is to present the abnormalities in the branching pattern of axillary artery with a view to clarification and quantification of both the “regularity” and “variability” in these vessels.Aim - The aim of this study is to present the variations in the branching pattern of axillary artery with a view to clarify and quantify both the “regularity” and “variability” in these vessels.Material and Methods – The current study was conducted on 40 formalin embalmed cadavers bilaterally, during routine dissection done at Punjab Institute of Medical Sciences, Jalandhar. The axillary artery and all of its branches were observed from their point of origin and traced to their termination, for any morphological variation.Results – Out of a total of 80 limbs studied, 21 showed variant branching pattern of Axillary artery. Six types of variations were noted in its branching pattern, with one type of variation being present bilaterally in two cadavers. One of the variations is a rare and unique entity. The percentage of variations were also calculated to fulfil the objective of this study holistically.Conclusion - Such anomalous branching pattern may represent persisting branches of the capillary plexus of the developing limb buds. These variations have pragmatic importance for surgeons for accurate diagnosis and surgical procedures and also for vascular radiologists for construing angiographic images.
axillary, cadaveric, branching, morphological, variation, anomalous
Copyright (c) 2026 HARPREET SINGH GULATI, JASVEEN KAUR, MAMTA SHARMA, KAMALJEET KAUR, AMBICA WADHWA, URVI PRASHAR (Author) https://creativecommons.org/licenses/by-nc/4.0
Pre Op PTA & HRCT as prediction of ossicular chain status among CSOM patients: An Observational Study
Background: Chronic Otitis Media (COM) is a prevalent condition associated with varying degrees of hearing loss, often due to ossicular chain damage. Pure Tone Audiometry (PTA) is routinely used to assess hearing impairment; however, its correlation with intraoperative ossicular status remains crucial for preoperative planning. Aim: To evaluate the correlation between Pure Tone Audiometry findings and ossicular chain status in patients with Chronic Otitis Media. Materials and Methods: A prospective observational study was conducted on 183 patients diagnosed with COM. Preoperative PTA was performed to assess hearing thresholds and type of hearing loss. Intraoperative findings regarding ossicular integrity were recorded during tympanoplasty or mastoid surgery. Statistical correlation was analyzed between PTA findings and ossicular status. Results: Among 183 patients, 62.3% had intact ossicular chain, while 37.7% showed ossicular discontinuity. Overall ossicles status was normal among 59(52.7%) mild CHLM 36(32.1%) moderate CHL patients and 8(7.1%) among Moderately Severe CHL. Eroded among 9(8.0%) Moderate CHL patients. There was a statistically highly significant difference found in ossicle status in CT according to severity of PTA among mucosal ear patients. (P=0.001) Ossicular erosion was significantly higher in unsafe COM compared to safe COM, indicating the aggressive nature of cholesteatoma-related disease. There was a statistically significant difference found in ossicles status between squamosal and mucosal patients. (P<0.05). Increasing air-bone gap (ABG) was significantly associated with ossicular erosion (p < 0.001). Patients with ABG >40 dB predominantly had multiple ossicular involvement. Conclusion: PTA findings, particularly air-bone gap, serve as a reliable predictor of ossicular status in COM. This correlation aids in surgical planning and patient counseling.
Chronic Otitis Media, Pure Tone Audiometry, Ossicular Chain, Hearing Loss, Air-Bone Gap
Copyright (c) 2026 Dr. Gaurav Tripathi, Dr. Sadat Qureshi, Dr. Shalini Jadia, Dr. Sandeep Sharma (Author) https://creativecommons.org/licenses/by-nc/4.0
Effect of severity of Allergic Rhintis on tympanic membrane status : A Correlational Study
Background: Allergic rhinitis (AR) is a common inflammatory condition affecting the nasal mucosa and often associated with Eustachian tube dysfunction, which may influence middle ear status and tympanic membrane (TM) findings.Objective: To evaluate the correlation between tympanic membrane findings and the severity of allergic rhinitis among 246 patients.Methods: This cross-sectional observational study was conducted in a tertiary care center. A total of 246 patients diagnosed with allergic rhinitis were included. Severity of AR was classified based on ARIA guidelines into mild and moderate–severe categories. Otoscopic examination was performed to assess TM findings. Statistical analysis was done to determine correlation.Results: Among 246 patients, abnormal TM findings were significantly higher in moderate–severe AR patients (p < 0.05). Retraction and dull TM were the most common findings. A strong association was observed between severity of AR and middle ear changes.Conclusion: Increased severity of allergic rhinitis is significantly associated with abnormal tympanic membrane findings, suggesting the role of Eustachian tube dysfunction in AR.
Allergic rhinitis, Tympanic membrane, Eustachian tube dysfunction, Otoscopy, ARIA classification
Copyright (c) 2026 Dr. Vinisha Wilson, Dr. Sadat Qureshi, Dr. Shalini Jadia, Dr. Sandeep Sharma (Author) https://creativecommons.org/licenses/by-nc/4.0
Nasal Endoscopy and Computed Tomography Findings in Patients of Chronic Rhinosinusitis - A Correlation Study
Background: Chronic rhinosinusitis (CRS) is a common inflammatory condition affecting the nasal cavity and paranasal sinuses, significantly impairing quality of life. Accurate diagnosis is essential for effective management and prevention of complications. Diagnostic nasal endoscopy (DNE) and computed tomography (CT) are essential tools in its evaluation. Correlating findings from these two modalities is crucial for comprehensive evaluation and appropriate treatment planning in patients with CRS.Aim: To correlate computed tomographic findings with endoscopic findings in patients of chronic rhinosinusitis.Materials and Methods: A cross-sectional observational study was conducted on 170 patients diagnosed with CRS. The patients above 15 years fulfilling inclusion criteria were included. Each patient underwent detailed clinical evaluation, diagnostic nasal endoscopy, and CT scan of paranasal sinuses. Data were analyzed using SPSS software, and correlation was assessed using Spearman’s correlation coefficient.Results: Significant correlation was observed between endoscopic and CT findings in mucosal edema, polyps, and middle meatal obstruction (p < 0.05). A statistically significant correlation was found between endoscopic and CT findings for septum (rs=1.000, p=0.01), turbinate hypertrophy, ethmoid bulla, and osteomeatal complex on both sides. A strong correlation was also observed for left osteomeatal complex (rs=0.995, p=0.001). CT scan showed superior detection of anatomical variations and sinus involvement, while endoscopy better identified mucosal changes and secretions.Conclusion: There is a strong and statistically significant correlation between diagnostic nasal endoscopy and CT findings in CRS. Both modalities are complementary, and their combined use provides accurate diagnosis and better management planning.
Chronic rhinosinusitis, Diagnostic nasal endoscopy, Computed tomography, Osteomeatal complex, Correlation
Copyright (c) 2026 Dr. Pooja Handique, Dr. Shalini Jadia, Dr. Sadat Qureshi, Dr. Sandeep Sharma (Author) https://creativecommons.org/licenses/by-nc/4.0
Knowledge, Attitude and Practices regarding Hepatitis B infection among young adults of a university in an Urban city in South India
Background: Hepatitis B Virus (HBV) remains a significant global public health concern, with varying morbidity and mortality in India and other low and middle income countries (LMICs). Even with an effective vaccine for Hepatitis B virus infections, knowledge and practice gaps are common, particularly among young adults, who represent a critical part of the population for prevention strategies. Very limited number of studies from India have examined the knowledge, attitudes, and practices (KAP) of students regarding HBV in colleges and universities other than medical colleges.Objectives: To assess KAP regarding HBV among young adults enrolled in a university in urban South India, identify lacunae across KAP domains, and examine statistical correlations among these.Methodology: This descriptive cross-sectional study involved 148 university students aged 18–26 years, surveyed using a self-designed, expert-validated questionnaire. Data analysis was conducted with SPSS v18. Knowledge scores were classified as good (≥70%), average (50–69%), or poor (<50%) based on the percentage of correct answers. For relationship between KAP domain scores Pearson’s correlation coefficient was used with p < 0.05 as significant.Results: Knowledge of HBV among the participants was generally poor to average. Only 24.3% identified all routes of transmission, 18.9% knew that HBV could be asymptomatic, and 27.7% knew the correct vaccination schedule. Only 53 participants (35.8%) reported being vaccinated against HBV, and 37.8% were unsure of their vaccination status. Attitudes were predominantly positive (>80% across all indicators). Correlation analysis showed strong association between knowledge and practice (r = 0.654, p < 0.0001), a moderate correlation between knowledge and attitude (r = 0.422, p < 0.0001), and a weak but significant correlation between attitude and practice (r = 0.273, p = 0.0008).Conclusion: Despite good responses for attitudes, there are gaps in knowledge and vaccination practices for HBV infection among young adults. The strong knowledge–practice correlation underscores the importance of health education among the groups. The implementation of university-led awareness and immunization initiatives is essential to advance India’s objectives for viral hepatitis elimination by 2030.
Hepatitis B; KAP survey; University students; Vaccination coverage; Preventive health; South India
Copyright (c) 2026 Rhea George, Priyadharsni Panneerselvam, Alpana Gupta, George Koshy (Author) https://creativecommons.org/licenses/by-nc/4.0
Artificial Intelligence in Diagnostic Pathology: A Comprehensive Review of Current Applications and Future Prospects
Artificial intelligence (AI) is transforming diagnostic pathology by improving the accuracy, efficiency, and repeatability of histopathological examinations. AI systems can analyze high-resolution whole slide images (WSIs) using machine learning (ML) and deep learning (DL) algorithms to diagnose malignancies, classify tissue types, grade cancers, and quantify biomarkers with accuracy comparable to expert pathologists. These technologies are very useful in cancer diagnosis, such as breast, prostate, and lung malignancies, where they help identify tumor characteristics, mitotic activity, and lymph node metastases. Furthermore, AI is being utilized to predict prognosis, evaluate therapy response, and detect infectious pathogens in tissue samples.AI integration into digital pathology operations has numerous benefits, including faster diagnostic turnaround times, increased consistency, and support for remote consultation and telepathology. However, issues persist in terms of data quality, model generalization across populations and institutions, and the need for rigorous clinical validation. Regulatory permissions and ethical considerations such as data protection, algorithm transparency, and medico-legal accountability are also required for safe deployment. This review presents a comprehensive examination of existing AI applications in pathology, investigates the technology that enables this transition, and analyzes future possibilities. Understanding AI's function is critical for creating dependable, egalitarian, and successful diagnostic tools in contemporary pathology practice.
Artificial Intelligence, Diagnostic Pathology, Deep Learning, Whole Slide Imaging, Cancer Diagnosis
Copyright (c) 2026 Belukurichi Sadasivam Sangeetha, Suriakumar. J, T. Murugalakshmi, Devi.J, R. Akila (Author) https://creativecommons.org/licenses/by-nc/4.0
Tumor Grade and Molecular Prognostic Markers in Endometrial Carcinoma: A Systemic Review & Meta Analysis
Background: Endometrial carcinoma (EC) is a biologically heterogeneous malignancy in which traditional histopathological grading alone does not reliably predict clinical outcomes. Recent advances in molecular classification have introduced novel prognostic markers that may refine risk stratification.Objective: To evaluate the correlation between tumor grade, key molecular markers, and survival outcomes in patients with endometrial carcinoma through a systematic review and meta-analysis.Methods: A comprehensive literature search was performed across PubMed, Scopus, Embase, and Web of Science up to January 2026. Studies assessing tumor grade in conjunction with molecular markers-primarily POLE mutations, mismatch repair deficiency (MMRd), and p53 abnormalities-and reporting survival outcomes were included. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled using a random-effects model.Results: Thirty-eight studies comprising 12,450 patients were included. High tumor grade (Grade 3) was significantly associated with poorer overall survival (HR 2.14, 95% CI 1.78–2.56) and progression-free survival (HR 1.96, 95% CI 1.61–2.38). Molecular classification revealed distinct prognostic groups: POLE-mutated tumors demonstrated excellent prognosis (HR 0.45), MMR-deficient tumors showed intermediate outcomes (HR 0.89), while p53-abnormal tumors were associated with the worst survival (HR 2.76). Integrated analysis combining tumor grade with molecular markers significantly improved prognostic accuracy compared to grading alone.Conclusion: Molecular markers provide superior prognostic stratification over conventional tumor grading in endometrial carcinoma. The integration of histopathological and molecular classification should be adopted in routine clinical practice to enable more precise, individualized patient management.
Endometrial carcinoma, tumor grade, molecular markers, prognosis, systematic review, meta-analysis
Copyright (c) 2026 Tasneem Muhammed Sherief, Shipra Singh, Hemanth Kumar VM (Author) https://creativecommons.org/licenses/by-nc/4.0
Categorization of Thyroid FNAC Using the Bethesda System and Its Histopathological Correlation
BackgroundThyroid nodules are common endocrine lesions, with the primary clinical challenge being the identification of malignancy among predominantly benign cases. Fine-needle aspiration cytology (FNAC), reported using the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), provides standardized risk stratification; however, its diagnostic performance requires validation through histopathological correlation.MethodsThis observational study was conducted over two years at a tertiary care center. A total of 122 patients with thyroid swelling underwent FNAC, of which 83 had subsequent histopathological follow-up. Cytological findings were categorized according to TBSRTC. Cytohistopathological correlation was performed, and the risk of malignancy (ROM) was calculated for each category. The diagnostic performance parameters, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were determined using histopathology as the reference standard.ResultsThe majority of cases were categorized as Bethesda Category II (81.15 %). Histopathological examination revealed that 83.13% of the lesions were non-neoplastic and 16.87% were neoplastic, with papillary carcinoma being the most common malignancy. The concordance rates were 89.86% and 78.57% for non-neoplastic and neoplastic lesions, respectively. The ROM increased progressively from Category I (0%) to Category VI (100%). FNAC demonstrated a sensitivity of 78.57%, specificity of 89.85%, PPV of 61.11%, NPV of 95.38%, and an overall diagnostic accuracy of 87.95%.ConclusionFNAC, when interpreted using the Bethesda system, is a reliable and effective initial diagnostic modality for thyroid nodules. Cytohistopathological correlation enhances diagnostic accuracy and highlights the limitations of indeterminate categories. Standardized reporting using the TBSRTC facilitates appropriate clinical management and reduces unnecessary surgical interventions.
Bethesda system; Cytohistopathological correlation; Diagnostic accuracy; Fine-needle aspiration cytology; Risk of malignancy; Thyroid nodules
Copyright (c) 2026 Dr. Suman Gupta, Dr. Anil Kumar Verma, Dr. Firoz Sheikh, Dr. Chandni Krishnani (Author) https://creativecommons.org/licenses/by-nc/4.0
OCULAR MANIFESTATIONS OF AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASES
INTRODUCTION: At about 6 weeks of gestation both eyes and kidney start to develop and hence they have a strong connection. As a result, a patient who suffers from any kidney disease end up with different ocular disease manifestation. Many congenital anomalies of kidneys can also present as an ocular syndrome. Autosomal dominant polycystic kidney disease (ADPKD) is an inherited kidney disease, which also manifests numerous eye problems. The study helps to identify the ocular associations with ADPKD with creates an awareness towards frequent eye checkup.AIMs and OBJECTIVES: To report the ocular manifestation of Inherited Renal Disease and to identify and characterize the ocular manifestation among patients diagnosed with inherited renal disease. This is a hospital based Cross sectional study, 61 patients were includedRESULTS: Most common ocular complaint was blurring of vision in 52 (85.24%) patients. After refractive error (55.73%), next most common ocular manifestations are, Arcus senilis (36.10%) and hypertensive retinopathy (34.2%). 39 (63.93 %) had no history of previous eye check-up. Most affected age group was patients aged > 35 – 40 years.CONCLUSION: Ocular manifestations can occur before systemic effects of disease starts to appear, thus identifying characteristic ocular manifestation can give a clinical clue allowing definitive diagnosis without expensive and invasive procedures in early course of disease allowing timely intervention.
ADPKD, eye, Arcus senilis, retinopathy, kidney, ocular disease
Copyright (c) 2026 Sankha Subhra Chaudhuri, Mousumi Bandypadhyay, Kali Sankar Das, Soumyadeep Majumdar, Madhurima Kumar, Purban Ganguly (Author) https://creativecommons.org/licenses/by-nc/4.0
Speciation and Antibiotic Susceptibility Pattern of staphylococcus species other than staphylococcus aureus Isolated from various Clinical Samples at a Tertiary Care Hospital in Rajasthan
Background: Staphylococci species other than Staphylococcus (CoNS) are increasingly recognized as significant pathogens in clinical settings, particularly among hospitalized and immunocompromised patients. Rising antimicrobial resistance has become a major concern.Materials and Methods: This cross-sectional study included 37 clinically significant CoNS isolates obtained from various clinical samples. Identification of isolates was done using standard microbiological methods. Antimicrobial susceptibility testing was performed by the “Vitek* 2compact automated system” (biomerieux)Results: Among the isolates, Staphylococcus haemolyticus 16(43.2%) was the most common species, followed by Staphylococcus epidermidis 11(29.7%) and Staphylococcus hominis 7(18.9%). A high level of resistance was observed to penicillin, oxacillin, indicating a high prevalence of methicillin-resistant CoNS (MRCoNS). Resistance to ciprofloxacin and erythromycin was also notable. Moderate resistance was seen for gentamicin, clindamycin, and cotrimoxazole. All isolates showed high susceptibility to vancomycin, Daptomycin, teicoplanin, and linezolid. Inducible clindamycin resistance was detected in a subset of isolates.Conclusion: CoNS are emerging as important multidrug-resistant pathogens. High resistance to commonly used antibiotics limits treatment options; however, glycopeptides (Teicoplanin, Vancomycin and linezolid remain effective. Routine speciation, antimicrobial surveillance and strict infection control practices are essential for better management and prevention of resistance.
CoNS, MRCoNS, Staphylococcus haemolyticus, gentamicin, clindamycin, and cotrimoxazole
Copyright (c) 2026 Harish Kumar, Siva Prasad Reddy B, Pragati Awasthi, Madhu Mali, Khushal Singh Beniwal (Author) https://creativecommons.org/licenses/by-nc/4.0
Frequency of multi drug resistant (MDR) Proteus species in clinical sample at tertiary care hospital.
Background: Multidrug-resistant (MDR) Proteus species are becoming significant hospital-related pathogens linked to infections in wounds, the urinary tract, and the bloodstream. The rise of antimicrobialresistance restricts treatment choices and presents a significant clinical hurdle.Methods: A cross-sectional study was performed involving 37 unique MDR Proteus isolates collected from different clinical specimens. Species identification and antimicrobial resistance testingwere conducted using conventional microbiological techniques.Results: Out of 59 Proteus isolates 45 (76.6%) were Proteus mirabilis followed by 14 (23.7%) Proteus vulgaris. Out of 37 MDR of Proteus species isolates, Proteus mirabilis comprised 32 (86.5%) and Proteus vulgaris represented 5 (13.5%). Most cases were observed in patients older than 60 years (45.9%),with a higher prevalence in males (64.9%). Pus samples made up 56.8% of the isolates. Significant resistance was noted to cefepime (94.6%), ceftazidime (78.4%), and cefoperazone–sulbactam (70.3%). The resistance rate to piperacillin-tazobactam stood at 59.5%.Conclusion: P. mirabilis, are found leading factor to wound and systemic infections, exhibiting substantial resistance among the proteus species againstcephalosporins. Ongoing monitoring and proper use of antimicrobials are crucial for managing their dissemination.
Multidrug resistance, Proteus mirabilis, Proteus vulgaris, antimicrobial resistance, tertiary care hospital
Copyright (c) 2026 Rakesh Kumar Maheshwari, Nirbhay Nirmal, Prachi Saban, Pragati Awasthi, Madhu Mali, Khushal Singh Beniwal (Author) https://creativecommons.org/licenses/by-nc/4.0
Emerging Carbapenem Resistance in Escherichia coli and Klebsiella pneumonia isolates from a Tertiary Care Hospital in Rajasthan.
Introduction:Carbapenem-resistant Enterobacterales, especially Escherichia coli and Klebsiella pneumoniae, are becoming a serious health problem. These bacteria cause many hospital infections and are difficult to treat because they are resistant to strong antibiotics. This leads to increased illness and death.Materials and Methods:This was a hospital-based cross-sectional study done over one year at a tertiary care center in Rajasthan. A total of 366 clinical samples were studied. The bacteria were identified and their antibiotic sensitivity was tested using standard laboratory methods.Results and Discussion:Out of 366 isolates, 202 (55.2%) were E. coli and 164 (44.8%) were Klebsiella pneumoniae. Most isolates were obtained from urine, pus, respiratory samples, and blood. Carbapenem resistance was seen in both organisms, but it was higher in Klebsiella pneumoniae. Resistance to important antibiotics like imipenem, meropenem, and ertapenem shows the growing problem of drug resistance. Elderly patients were more commonly affected, suggesting age as an important risk factor. Also, more cases were seen in males (66.6%). These findings show that multidrug resistance is increasing and is a major concern in hospitals.Conclusion: This study shows a high level of carbapenem resistance among Escherichia coli and Klebsiella pneumoniae. Regular monitoring, proper infection control, and careful use of antibiotics are very important to control the spread of these resistant bacteria and to protect effective treatments.
Copyright (c) 2026 Siva Prasad Reddy B, Priti, Prachi Saban, Pragati Awasthi, Madhu Mali (Author) https://creativecommons.org/licenses/by-nc/4.0
ASSOCIATION BETWEEN QTc INTERVAL AND SEVERITY OF CIRRHOSIS IN PATIENTS DIAGNOSED WITH LIVER CIRRHOSIS: A CROSS-SECTIONAL STUDY
Background: Liver cirrhosis is a systemic disease with significant cardiovascular involvement, particularly in the form of cirrhotic cardiomyopathy. Prolongation of the corrected QT (QTc) interval is one of the most consistent electrophysiological abnormalities observed in cirrhotic patients and has been linked to adverse outcomes, including arrhythmias and increased mortality.Aim: To evaluate the association between QTc interval and severity of cirrhosis in patients diagnosed with liver cirrhosis.Methods: This cross-sectional study was conducted in a tertiary care center and included 100 patients with clinically diagnosed liver cirrhosis. QTc interval was measured using a standard 12-lead electrocardiogram and calculated using Bazett’s formula. Severity of cirrhosis was assessed using the Child–Turcotte–Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores. Statistical analysis was performed using SPSS version 27, with p < 0.05 considered significant.Results: The majority of patients were male (76%) and belonged to the 41–60-year age group. Alcohol was the predominant etiological factor (62%). QTc prolongation was commonly observed and showed a significant positive correlation with severity of cirrhosis. Patients with higher Child–Pugh classes and elevated MELD scores demonstrated progressively increased QTc intervals (p < 0.05). QTc prolongation was more pronounced in advanced disease stages, indicating worsening electrophysiological dysfunction with progression of liver disease.Conclusion: QTc interval prolongation is significantly associated with the severity of liver cirrhosis and may serve as a simple, non-invasive, and cost-effective prognostic marker. Routine assessment of QTc interval in cirrhotic patients can aid in early identification of high-risk individuals and facilitate timely intervention to reduce cardiovascular complications and mortality.
Liver cirrhosis, QTc interval, Child–Pugh score, MELD score, cirrhotic cardiomyopathy, electrocardiography
Copyright (c) 2026 Manpreet Kaur, Avtar Singh Dhanu, Surinder Kumar Salwan, Humraaz Singh Randhawa (Author) https://creativecommons.org/licenses/by-nc/4.0
ADMISSION BLOOD GLUCOSE LEVEL AS A PREDICTOR OF IN-HOSPITAL MAJOR ADVERSE CARDIOVASCULAR EVENTS IN NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME
Background: Acute coronary syndrome (ACS) remains a major cause of morbidity and mortality worldwide. Despite advances in reperfusion strategies and pharmacotherapy, a significant number of patients develop in-hospital major adverse cardiovascular events (MACE). Admission hyperglycemia has emerged as a potential prognostic marker even in patients without known diabetes mellitus. The present study evaluated the role of admission blood glucose in predicting in-hospital MACE among non-diabetic ACS patients.Methods: This prospective observational study was conducted in the Department of Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India. Eighty-two non-diabetic adults admitted with ACS were enrolled. Patients with known diabetes or HbA1c ≥5.7% were excluded. Admission random blood sugar (RBS) was measured, and patients were categorized into normoglycemic (<140 mg/dL) and hyperglycemic (≥140 mg/dL) groups. Patients were followed during hospitalization for development of MACE, including cardiogenic shock, arrhythmias, heart failure, reinfarction, and cardiac arrest. Statistical analysis was performed using SPSS.Results: The mean age group most affected was 51–70 years (54.88%), and males constituted 73.2% of cases. Hyperglycemia was present in 50% of patients. Significant associations were observed between admission hyperglycemia and cardiogenic shock (85.7% vs. 14.3%, p=0.001), arrhythmias (76.5% vs. 23.5%, p=0.014), cardiac arrest (88.8% vs. 11.1%, p=0.029), and pulmonary edema (85.2% vs. 14.8%, p=0.001). No significant association was seen with heart failure, myocardial reinfarction or duration of hospital stay.Conclusion: Admission hyperglycemia is a strong predictor of adverse in-hospital cardiovascular outcomes in non-diabetic ACS patients. Routine glucose assessment at admission may aid in early risk stratification and identification of high-risk patients requiring closer monitoring and aggressive management.
Acute coronary syndrome, hyperglycemia, non-diabetic, MACE, cardiogenic shock, arrhythmia, prognosis, STEMI, NSTEMI, blood glucose.
Copyright (c) 2026 Raunak Singh Kapoor, Jasmine Kaur, Avtar Singh Dhanju (Author) https://creativecommons.org/licenses/by-nc/4.0
Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction: A Systematic Review of Efficacy, Patient Selection, and Optimal Treatment Parameters
Background: Erectile dysfunction (ED) is a prevalent condition affecting men across all age groups, with a significant impact on quality of life, self-esteem, and interpersonal relationships. Low-intensity extracorporeal shockwave therapy (Li-ESWT) has emerged as a promising non-invasive treatment modality demonstrating improvements in erectile function with a favourable safety profile. However, the evidence base remains heterogeneous, and consensus regarding patient selection, optimal treatment protocols, and long-term sustainability of effects is lacking.Objective: To provide a critical, clinician-oriented synthesis of the current evidence on the effectiveness, safety, optimal patient profile, and treatment parameters of Li-ESWT in the management of ED.Methods: A systematic literature search of PubMed, MEDLINE, Cochrane Library, EMBASE, and grey literature databases was conducted for articles published from 2016 to 2023. Following PRISMA 2020-guided screening of 1,302 titles, 164 abstracts, and 94 full-text articles, 20 studies were included. Quality assessment was performed using the Newcastle-Ottawa Scale, STROBE Checklist, and Cochrane Risk of Bias Tool (RoB 2). A narrative synthesis approach was employed in keeping with UK Economic and Social Research Council guidance.Results: All included studies reported post-treatment improvements in erectile function as measured by the International Index of Erectile Function (IIEF). Li-ESWT demonstrated statistically significant benefits for organic vasculogenic and diabetic ED, with minimal clinically important difference (MCID) rates ranging from 22% to 86.4%. Li-ESWT was comparable in efficacy to phosphodiesterase-5 (PDE5) inhibitors with a superior safety profile. Evidence did not support its use for post-radical prostatectomy ED. Twelve treatment sessions at 0.09 mJ/mm², delivered twice weekly in a 3+3+3-week schedule, constituted the most commonly reported effective protocol. Treatment benefits were sustained in up to 82.69% of respondents at 12 months, with gradual decline thereafter.Conclusion: Li-ESWT is a safe, well-tolerated, and effective treatment for organic erectile dysfunction, particularly in younger men with vasculogenic or diabetic aetiology and moderate severity. It is comparable to PDE5 inhibitors and may be a viable alternative or complementary option in clinical practice. Future high-quality, multi-centre randomised controlled trials with standardised protocols and longer follow-up periods are warranted.
erectile dysfunction; low-intensity extracorporeal shockwave therapy; Li-ESWT; phosphodiesterase-5 inhibitors; vasculogenic erectile dysfunction; IIEF; penile rehabilitation
Copyright (c) 2026 Krischelle de Guzman Halili, Smita Satpathy (Author) https://creativecommons.org/licenses/by-nc/4.0