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
Vitamin D Status in AMI Patients: Correlation with Cardiovascular Risk Factors
Acute myocardial infarction (AMI) is a leading cause of illness and death around the world. Vitamin D deficiency has been linked to the development of atherosclerosis through various mechanisms such as vascular inflammation, problems with blood vessel function, foam cell formation, and the growth of vascular smooth muscle cells (VSMCs). Therefore, this case-control study aimed to compare serum Vitamin D levels in AMI patients with and without risk factors such as hypertension (HTN), diabetes, smoking, and high cholesterol. The study included 100 subjects: 50 healthy volunteers as controls (Group 1) and 50 patients diagnosed with AMI according to WHO criteria (Group 2). Group 2 was further divided based on the presence of risk factors, and patients were categorized according to Vitamin D status as deficient (≤20 ng/mL) or insufficient/sufficient (>20 ng/mL). Data were analyzed using GraphPad Prism version 8.2.1. Mean serum Vitamin D levels were significantly lower in AMI patients (13.03 ± 8.45 ng/mL) compared to controls (35.82 ± 3.50 ng/mL). Among AMI patients, Vitamin D levels were lowest in those with diabetes (11.53 ± 6.71 ng/mL), followed by smokers (13.19 ± 8.09 ng/mL), patients with high cholesterol (13.28 ± 8.59 ng/mL), and those with hypertension (14.31 ± 9.61 ng/mL). Low serum Vitamin D levels are closely linked to AMI, especially in patients with common cardiovascular risk factors. Vitamin D deficiency may worsen atherosclerosis by promoting problems with blood vessel function, increasing VSMC growth, migration and calcification, and driving inflammatory and immune-related processes.
Acute Myocardial Infarction, Cardiovascular Disease, Diabetes, Hypertension, Hyperlipidemia, Smoking, and Vitamin D.
Copyright (c) 2026 Dr. Deva Pragna Prashanthi, Dr. Patti Anusha rani, Dr. Shivakrishna Gouroju, Revupalli Suneetha (Author) https://creativecommons.org/licenses/by-nc/4.0
Depression in Tuberculosis: Patients versus Attendants
Introduction: Tuberculosis with depression is a vicious cycle of underdiagnosed syndemic. Reported number of cases vary widely - may be due to ambiguity in defining family support, and/or different depression measuring scales. Aim: Aim of this study is to find 1. Incidence and extent of depression in tuberculosis inpatients 2. Estimate and correlate the same in attendants 3. To compare two depression scores in each case. Materials and methods: A cross-sectional study of quantitative distribution of depression score on 2 different scales, in 19 newly diagnosed tuberculosis inpatients, apropos their one attending family member was assessed. Wilcoxon’s Signed Rank Test was used to compare the 2 scale outcomes. Results: Patients’ depression score was never negligible (£16). One borderline clinical depression, 10 moderate depressions, 4 severe depressions, and 4 extreme depressions were elicited. There was an age-wise bimodality of depression in patients – unseen among attendants. The depression scores in 19 patient-attendant pairs didn’t match. Among attendants, 8 normal ups-and-downs, 5 mild mood disturbances, 3 mild depressions, and 3 moderate depressions were elicited. The two depression scores were statistically similar (in patients: p = 0.3866; in attendants: p = 0.6318) at 95% confidence level. As per patient-attendant relation, in brother-brother, father-son, son father, mother daughter, and daughter-mother – but for few exceptions – a rising trend was seen. Conclusion: Depression-tuberculosis syndemic was nearly universal. Attendants’ mental health was an ancillary concern. Age-wise bimodality of depression in patients indicated an extra thrust area. Among attendants, depression score matched more with emotional parentality and gender.
Copyright (c) 2026 Prachi B Mehta, Sana R Pathak, Pragna M Sorani, Om V Solanki, Kishan D Shiyal (Author) https://creativecommons.org/licenses/by-nc/4.0
Blood Component Utilization Pattern and Crossmatch-to-Transfusion Ratio in a Tertiary Care Hospital: An Ambispective Blood Bank Audit
Background:Components of blood are limited resource for therapy and should be used in a rational way. There is a high demand for transfusions at tertiary care hospitals because of requirements of various medical specialties such as medicine, surgery, obstetrics and gynecology, emergency care, pediatrics, intensive care etc. Regular audits of blood utilization using transfusion indices are capable of revealing unnecessary overordering, ineffective blood reserving, wasted components and other ways to improve transfusion practice.Aim:To analyze blood component utilization and crossmatch-to-transfusion ratio at a tertiary care hospital through ambispective audit of the blood bank.Material and Methods:An ambispective observational study was performed in the blood bank of a tertiary care hospital over three years. The first two years were retrospective, and the last year was prospective. Data were obtained from donor records, registers of component preparation, crossmatches, issues, returns, discards, transfusion reactions and prospectively filled proformas. Utilization data per component type and department were analyzed. Crossmatch-to-transfusion ratio, probability of transfusion, transfusion index, return rate, and discard rate were calculated. Results: A total number of 16,482 blood bags were collected and 31,842 blood components were issued over the studied period. The largest component group was the packed red blood cells, then fresh frozen plasma and platelet concentrates. The major users of the blood bank were Departments of Medicine, Obstetrics and Gynecology, Surgery, Emergency Medicine and Intensive Care Units. The overall crossmatch-to-transfusion ratio was 1.16, probability of transfusion was 83.5% and the transfusion index was 1.51. Department of Surgery and Orthopedics had comparatively higher values of crossmatch-to-transfusion ratio than Departments of Emergency, Intensive Care, Obstetric, Pediatric and Medical departments. The results obtained during prospective period were better concerning the documentation of clinical indication, confirmation of transfusion, returning of unused blood units and reasons for discard. Conclusion:There was variation in utilization of blood components on a department level which was clinically significant. Overall utilization of red cells was acceptable, but some procedural departments needed improvement of blood reserving practices. Periodic audits, feedbacks, better documentation and development of local blood ordering guidelines could enhance rational blood component utilization at tertiary care hospitals.
Blood component utilization; Crossmatch-to-transfusion ratio; Transfusion probability; Transfusion index; Blood bank audit; Tertiary care hospital; Component therapy.
Copyright (c) 2026 Dr Shrinivasanand Madhavrao Patil , Dr Shital Uttamrao Ranvir, Dr Pooja Maroti Nagargoje (Author) https://creativecommons.org/licenses/by-nc/4.0
The Role of Medicinal Plants in Bone Healing: A Scoping Review
Bone fractures are among the most common traumatic injuries worldwide with an estimated 178 million new cases in 2019, reflecting a 33.4% increase since 1990. Contributing factors include injuries, communicable and non-communicable diseases and nutritional deficiencies. Bone healing is vital for maintaining function. While modern treatments often require advanced facilities, medicinal plants have traditionally been used to aid bone repair. This review discusses selected medicinal plants with evidence-based support, focusing on their bioactive components and mechanisms of action. Comprehensive searches across four databases, from inception to May 2021 were performed following the PRISMA-ScR protocol. A total of 813 articles were identified, screened and narrowed to eligible studies. Plants such as Piper sarmentosum, Tridax procumbens, Sambucus williamsii Hance, Lepidum sativum, Peperomis pellucida and Prunus dulcis demonstrated beneficial effects on fracture healing. IN conclusion, certain medicinal plants show promise in promoting bone healing, offering valuable alternatives to advanced treatments.
Medicinal plants, Piper sarmentosum, Tridax procumbens, Sambucus williamsii Hance, bone healing.
Copyright (c) 2026 Basma Ezzat Mustafa Alahmad, Yulia Anesha Hashim, Muhd Ridzuan Pauzi, Nur Armidha Nadihah Amir Sabri, Nuraini Binti Che Aziz, Sama Naziyah Shaban, Faraedon M Zardawi, Khairani Idah Mukhtar, Nazih Shaban Mustafa, Nur Ain Sofia Roslan (Author) https://creativecommons.org/licenses/by-nc/4.0
Clinical and CT-Guided Decision Making in Adhesive Small Bowel Obstruction: A Single Center Prospective Study
Background: Adhesive small bowel obstruction (ASBO) is one of the common causes of readmission after any abdominal surgery in adults. While current guidelines suggest an initial conservative management trial, the value of computed tomography (CT) findings to predict the failure of nonoperative treatment is still unclear. Methods: This prospective, single-center cohort study included 41 adult patients with ASBO. All patients underwent standardized clinical assessment, CT imaging, and initial conservative management unless immediate surgery was indicated. CT variables, including mesenteric edema, small bowel feces sign, and intraperitoneal free fluid, were recorded. The outcomes of interest were the success or failure of conservative therapy, the need for surgery, intraoperative adhesion grade according to the Zühlke classification, postoperative complications, and length of hospital stay. Results: 30 patients (73.2%) were treated conservatively and 11 patients (26.8%) had early surgery. A total of 17 patients (41.5%) had to be operated on after the initial period of conservative treatment, and this was successful in 13 (31.7%). Mesenteric edema, small-bowel feces sign and intraperitoneal free fluid were not significantly associated with failure of conservative management or need for surgery in classical CT. Mean hospital stay was less in the patients in whom conservative treatment was successful than in the patients who underwent surgery. The predominant intraoperative adhesions were localized and single band, especially following midline laparotomy and laparotomy of the pelvis, while postoperative complications (mainly wound infection and pneumonia) were found in a significant number of the surgical patients. Conclusion: In this prospective cohort of patients with ASBO, commonly evaluated CT features were not useful for predicting the failure of conservative management and/or the need for surgery. Most patients eventually require surgical treatment after a period of nonoperative treatment, with considerable morbidity. This study suggests a multicenter approach with quantitative radiological scoring systems to define the optimal timing of surgery for ASBO and the pitfalls of CT-based decision-making.
Abdominal adhesions, Adhesive small bowel obstruction (ASBO), Nonoperative therapy, Surgical management, CT scan indicators, Mesenteric edema, Intraoperative adhesion classification
Copyright (c) 2026 Dr. Aditya Jirge, Dr. Jegan Mohan S, Dr Vijayendra Kedage, Dr Rajgopal Shenoy (Author) https://creativecommons.org/licenses/by-nc/4.0
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
Assessment of Physical Activity And Sleeping Pattern Among Medical Students And Their Impact On Academic Performance.
ABSTRACT Background &objectives:Medical education is academically demanding and often associated with irregular sleep patterns and reduced physical activity among students. Inadequate sleep and sedentary behavior may adversely affect cognitive functioning, stress levels, and overall academic performance. The present study was conducted to assess sleep quality and physical activity levels among MBBS students and to examine their association with academic performance. Methods:A cross-sectional survey was conducted among 254 undergraduate medical students at Shyam Shah Medical College, Rewa, M.P. Data was collected using a structured Google Form. The form included Demographic details of Participants, The International Physical Activity Questionnaire-short form (IPAQ-sf) to assess physical activity. The Pittsburgh Sleep Quality Index (PSQI) to assess sleep patterns. Academic performance was assessed using academic percentage scores obtained from internal assessments Results:Among the 254 participants, 39.4 per cent were females and 60.6 per cent were males. Majority of the students had poor sleep quality (69.3%). A statistically significant association was observed between physical activity levels and sleep quality (p=0.05). Physical activity levels were also significantly associated with academic grading (p<0.001). Academic percentage differed significantly according to gender and levels of physical activity (p<0.001). Conclusion:Physical activity demonstrated a significant association with academic performance among medical students, promotion of regular physical activity may contribute to improved academic performance and overall well-being among medical students.
Academic performance, medical students, Physical activity, PSQI, Sleep quality
Copyright (c) 2026 Dr. Vaishali Verma, Dr Shubhangi Nayak, Dr Anshuman Sharma, Dr. Neera Marathe (Author) https://creativecommons.org/licenses/by-nc/4.0
An Analytical Study of Heart Rate Variability in Newly Diagnosed Hypertensive Patients and Normotensive Subjects
Background: An adequate blood pressure is necessary for proper organ perfusion. Hypertension is a complex and non-communicable medical condition with increased blood pressure. The autonomic nervous system (ANS) regulates the cardiovascular system and sympathetic overactivity contributes not only to the initiation of essential hypertension but also to its progression and associated complications. Heart rate variability (HRV) is regarded as a non-invasive, sensitive measure of autonomic function, particularly useful for assessing sympathovagal balance. In this study, the changes in heart rate variability in patients of essential hypertension and age & sex matched healthy normotensive subjects were assessed. This study hypothesized that frequency domain parameters of heart rate variability may vary between patients with essential hypertension and in healthy normotensive subject. Material and methods: The present study was conducted on total 200 participants – 100 newly diagnosed essential hypertensive and 100 age & sex matched healthy normotensive subjects. Data collection was started after obtaining prior ethical approval from the institutional ethics committee. Anthropometric parameters were noted. HRV data was obtained using beat-to-beat human NIBP (non – invasive blood pressure) machine. Mean ± SD was used to expressed quantitative variables. Outcome variables were analyzed using parametric and non-parametric tests. Statistical significance was assigned at p-value<0.05. Results: The anthropometric parameters of essential hypertensive patients’ group and normotensive subjects’ group age, height weight and BMI were not statistically significant between the two groups. The mean ± SD difference of resting heart rate and resting blood pressure among hypertensive patients and normotensive subjects were statistically significant. The mean ± SD difference of HRV parameters among hypertensive patients and normotensive subjects were statistically significant. Conclusion: This study concluded that hypertensive patients have sympathovagal imbalance with increased sympathetic activity and decreased parasympathetic activity as compared to normotensive subjects.
Essential Hypertension, Heart rate variability, Beat-to-Beat Human NIBP, Adrenergic dominance, Sympathovagal balance
Copyright (c) 2026 Komal Sharma, Dr. Jyotsna Shukla (Author) https://creativecommons.org/licenses/by-nc/4.0
Evaluation of concept maps as a teaching–learning tool in teaching immunology to Phase II MBBS students and to assess their perception towards its use.
Background Immunology is a core subject in medical education that requires integration of complex concepts and clinical reasoning. Traditional teaching methods may limit meaningful learning and long-term retention. Concept mapping is an active learning strategy designed to enhance conceptual understanding, critical thinking, and student engagement. Objectives To evaluate the effectiveness of concept mapping as a teaching–learning strategy in immunology among Phase II MBBS students and to assess students’ perceptions regarding its role in promoting meaningful learning. Methods An educational interventional study was conducted in the Department of Microbiology at Dr. B. R. Ambedkar State Institute of Medical Sciences, Mohali, Punjab, India, from October to December 2024, after taking approval from Institutional Ethics Committee. Phase II MBBS students (n = 100) were enrolled, of whom 94 completed the study. Two immunology topics—innate and acquired immunity; and cytokines—were taught using concept mapping. Pre-test and post-test assessments using multiple-choice questions were conducted. Students participated in guided and self-directed concept mapping sessions. Student-generated maps were reviewed, and perceptions were assessed using a pre-validated five-point Likert scale questionnaire. Data were analyzed using SPSS version 27.0. Paired t-test was applied, and a p-value < 0.05 was considered statistically significant. Results The mean pre-test score was 9.41 ± 2.80, which significantly increased to 10.80 ± 2.27 in the post-test (p < 0.001). In the Stage 2 assessment, 80.3% of students achieved excellent scores. Feedback analysis revealed high satisfaction for quick revision (87.2%) and summarization skills (86.1%). More than 70% of students reported enhanced independent learning, problem-solving ability, and increased interest in immunology. Conclusion Concept mapping is an effective, student-centered teaching–learning strategy that improves conceptual understanding, academic performance, and learner engagement in immunology. Its integration into undergraduate medical curricula may promote meaningful learning, critical thinking, and lifelong learning skills.
Copyright (c) 2026 Sonia Mehta, Dr. Amit Aggarwal, Dr. Diljot Sandhu, Dr. Ritu Garg, Dr. Shreya Singh, Dr. Alisha Aggarwal (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
Functional outcome of closed reduction and percutaneous multiple K-wire fixation of displaced intra-articular calcaneal fracture
Background: Calcaneal fracture, being the most common tarsal bone fracture, accounts upto 65% of the cases, and 2% of all fractures. 75% of calcaneal fractures are intra-articular, which is the most common type of fracture. Displaced intra-articular calcaneal fractures (DIACF) are complex injuries associated with significant morbidity. Minimally invasive fixation seeks to restore the joint congruity while minimizing soft tissue complications seen in open approaches. In our study we evaluated the functional and radiological outcomes of closed reduction and percutaneous multiple K-wire fixation in DIACF.Methods: The study was carried out as a descriptive and prospective study in the Department of Orthopaedics, Calcutta National Medical College, Kolkata, India during the period July 2025 to December 2025. Thirty patients of 20 to 60 years, who underwent surgical fixation for displaced intra-articular calcaneal fracture using multiple K wires were followed up. Functional and radiological outcomes at six months follow up were assessed.Results: In our study of 30 patients with DIACF who underwent minimally invasive surgical fixation with k-wires, the mean final AOFAS score was 82.4 ± 6.7. Böhler angle improved from 8.6° preoperatively to 27.2° at final follow-up; Gissane angle corrected from 141.8° to 122.3°. Excellent-to-good outcomes were observed in 86.7% of patients. Complications occurred in 13.3% of cases, primarily superficial pin-tract infections; no deep infections or hardware failures were noted.Conclusion: Closed reduction and percutaneous K-wire fixation is an effective minimally invasive technique for selected DIACF, providing satisfactory functional recovery and radiographic restoration with low complication rates.
Calcaneus fracture, Percutaneous fixation, K-wire, Hindfoot, AOFAS
Copyright (c) 2026 Ashoke Kumar Chanda, Raju Mandal, Sudipta Dasgupta, Tirtharaj Debnath, Rakesh Das, Bibartan Guchait (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
Role of Glycemic Status, Dyslipidemia, and Kidney Function in the Development of Diabetic Retinopathy: A Tertiary Care Hospital-Based Study
Background Diabetic retinopathy is a major microvascular complication of diabetes mellitus and is a major cause of preventable blindness in diabetic patients around the world. The systemic risk factors that are thought to play an important role in the development and progression of DR include poor glycemic control, dyslipidaemia and renal dysfunction. Aim To investigate the role of glycemic status, dyslipidaemia and renal function in the onset of diabetic retinopathy in diabetic patients of a tertiary care hospital. Materials and Methodology A hospital based cross sectional observational study was conducted over a period of one year in collaboration with the department of Ophthalmology and Biochemistry at a tertiary case hospital. All 80 diagnosed diabetic patients were included in the study. A detailed clinical history and ophthalmological examination as well as biochemical investigations such as fasting blood glucose, HbA1c, lipid profile, serum creatinine, blood urea, estimated glomerular filtration rate (eGFR), and albuminuria were determined. The classification of diabetic retinopathy was done according to the classical grading systems of ophthalmology. Data was analyzed using SPSS Software and p-value <0.05 was considered as statistically significant. Results The age group of 51-60 years old represented the highest number of participants (37.5%) of which 57.5% were males participated in the study. Forty two and a half percent (42.5%) of patients suffered from diabetic retinopathy and mild non-proliferative diabetic retinopathy was the most prevalent stage (20.0%). Poor glycemic control showed significant association with diabetic retinopathy, as 66.7% of patients with HbA1c levels >9% had diabetic retinopathy compared to 16.7% among patients with HbA1c <7% (p <0.001). There was a significant association between elevated triglycerides and LDL cholesterol with diabetic retinopathy (p <0.05). Renal dysfunction was also significantly associated, and the prevalence of diabetic retinopathy in patients with albuminuria and eGFR <60 mL/min were 76.9% and 75.0%, respectively. Conclusion The rates of poor glycemic control, dyslipidaemia and renal dysfunction were independently significant in relation to the development of DR. Periodic eye exams and proper metabolic and renal surveillance may aid in earlier detection of high-risk diabetic patients and prevention of vision-threatening complications.
Albuminuria, Diabetes mellitus, Diabetic retinopathy, Dyslipidemia, Glycemic status, HbA1c, Kidney function, Microvascular complications
Copyright (c) 2026 Dr. Anuj Kumar, Dr. Rekha Choudhary, Dr. Piyush Kumar Singh (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
Physiological and Metabolic parameters associated with Ramadan Fasting among undergraduate Medical Students: A Prospective Observational Study
Background: Ramadan fasting is a form of intermittent fasting practised by Muslims worldwide during the ninth month of the Islamic lunar calendar. During this period, individuals refrain from consuming food, fluids, and smoking from dawn to sunset for nearly 29–30 consecutive days. Changes in dietary patterns and lifestyle during Ramadan may influence various anthropometric, cardiovascular, and metabolic parameters. Objective: The present study aimed to evaluate the effects of Ramadan fasting on anthropometric, cardiovascular, and metabolic parameters among undergraduate medical students. Materials and Methods: A prospective observational study was conducted among 140 healthy medical students of Mamata Academy of Medical Sciences, Hyderabad, during Ramadan (February–March 2026). Anthropometric and physiological measurements were recorded at two time points: before the commencement of Ramadan and at the end of the fasting period (30th day). Parameters assessed included body weight, body mass index (BMI), waist circumference, waist–hip ratio (WHR), heart rate, blood pressure, pulse pressure, mean arterial pressure (MAP), and random blood sugar (RBS).Results: A significant reduction in mean BMI was observed following Ramadan fasting compared to pre-fasting values (25.81 ± 6.1; p < 0.001). Mean mid-arm circumference was significantly lower among fasting individuals (26.7 ± 3.92 cm) compared to non-fasting individuals (28.39 ± 3.98 cm) (p = 0.01). In addition, fasting participants demonstrated lower heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and random blood sugar levels when compared with non-fasting participants. These differences were statistically significant (p < 0.05). Conclusion: The findings indicate that fasting has beneficial effects on anthropometric parameters, cardiovascular and metabolic health of individuals.
Ramadan fasting, body mass index (BMI), waist–hip ratio(WHR), blood pressure, random blood sugar.
Copyright (c) 2026 SYED IMRAN ALI, FARHA TARANNUM, HAJERA RABBANI, MOHAMMED AKBAR NAWAZ, SHAIK ZAIN SALEEM (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