Avascular necrosis (AVN) of the femoral head is a progressive disorder that predominantly affects young, active adults and frequently culminates in femoral head collapse and secondary osteoarthritis if left untreated. Core decompression combined with biological augmentation has been explored as a joint-preserving alternative to arthroplasty in early-stage disease. Autologous cultured osteoblasts, expanded ex vivo from the patient's own bone marrow or periosteal tissue, offer a theoretically attractive strategy to enhance osteogenesis at the necrotic focus while avoiding the immunogenicity and disease-transmission risks of allogeneic tissue. Objective: To evaluate the clinical and radiological outcomes of core decompression combined with implantation of autologous cultured osteoblasts in patients with ARCO Stage I and II avascular necrosis of the femoral head, over a minimum follow-up of six years. Materials and Methods: Fifteen hips in 13 patients (12 men, 3 women; mean age 33.8 years) with ARCO Stage I (n = 6) or Stage II (n = 9) AVN of the femoral head underwent core decompression followed by injection of culture-expanded autologous osteoblasts derived from iliac crest bone marrow aspirate. Patients were evaluated using the Harris Hip Score (HHS) and Visual Analogue Scale (VAS) for pain preoperatively and at 6 months, 1, 2, 3, 4, 5 and 6 years. Radiological staging (ARCO) and progression to collapse or conversion to total hip arthroplasty (THA) were recorded. Results: Mean HHS improved from 56.5 ± 6.2 preoperatively to 86.8 ± 8.5 at final follow-up (p < 0.001), and mean VAS score decreased from 6.5 ± 0.9 to 1.8 ± 1.3 (p < 0.001). Twelve of 15 hips (80%) showed no radiological progression at final follow-up. Three hips (20%) progressed radiologically to Stage III, of which one (6.7%) ultimately required conversion to total hip arthroplasty at 48 months. No major procedure-related complications occurred. Conclusion: Core decompression augmented with autologous cultured osteoblasts is a safe, reproducible, and effective joint-preserving option in ARCO Stage I and II AVN of the femoral head, providing durable pain relief and functional improvement and delaying or averting the need for arthroplasty in a majority of patients at 6-year follow-up. Larger, controlled, multicentric studies are warranted to confirm these findings.

Knee osteoarthritis (OA) is a leading cause of chronic pain and disability. Intra-articular high-concentration platelet-rich plasma (PRP) prepared as an autologous fibrin scaffold, combined with hyaluronic acid (HA) viscosupplementation, has been proposed as a synergistic biologic strategy to modulate the intra-articular environment and slow symptomatic progression. Objective: To evaluate the 3-year clinical and functional outcomes of a single-injection protocol combining ACP Max System-derived high-concentration PRP fibrin scaffold with HA viscosupplementation in patients with Kellgren-Lawrence (KL) grade 2 and 3 knee OA. Methods: In this prospective single-arm interventional study ( n = 96; KL grade 2, n = 54; KL grade 3, n = 42), patients received a single combined intra-articular injection prepared using the ACP Max double-syringe concentration system followed by HA supplementation. Outcomes (Visual Analogue Scale [VAS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Knee injury and Osteoarthritis Outcome Score [KOOS], Lysholm score) were recorded at baseline and 6, 12, 24, and 36 months. Results: Mean VAS improved from 6.8 ± 1.1 at baseline to 2.9 ± 1.3 at 36 months (data, p < 0.001). WOMAC total score improved from 58.4 ± 9.2 to 27.6 ± 10.1 (p < 0.001). KL grade 2 patients showed significantly greater and more durable improvement than KL grade 3 patients at 36 months (p = 0.01). No major adverse events were recorded; 6.3% reported transient post-injection synovitis. Conclusion: A single combined high-concentration PRP fibrin scaffold with viscosupplementation, here using the ACP Max System, was associated with sustained symptomatic and functional improvement over 3 years in early-to-moderate (KL 2–3) knee OA, with a more pronounced benefit in KL grade 2 disease. Controlled comparative trials with verified data are required to confirm these findings.

Introduction; - Anemia remains one of the most widespread public health problems globally, affecting individuals across all age groups, with a disproportionately high burden among women of reproductive age, adolescents, and low-income populations. Despite decades of national and international control programmes, low levels of community knowledge and awareness continue to hamper prevention efforts.  Objectives: This study aimed to assess the level of knowledge and awareness of anemia and its health consequences among adults residing in an urban community, and to identify the socio-demographic factors associated with adequate knowledge. Materials and Methods: A community-based, descriptive cross-sectional study was conducted among 420 adults aged 18–60 years selected by systematic random sampling. Data were collected using a pre-tested, semi-structured, interviewer-administered questionnaire covering socio-demographic characteristics, knowledge of causes, symptoms, prevention, and consequences of anemia, and sources of health information. Knowledge scores were categorized as poor, average, and good based on the total score obtained. Data were analyzed using descriptive statistics, Chi-square test, and binary logistic regression, with p<0.05 considered statistically significant. Results: Of the 420 participants, 56.7% were women. Only 34.0% of participants had good overall knowledge of anemia, while 41.4% had average knowledge and 24.6% had poor knowledge. Awareness of iron-deficiency as the commonest cause was reported by 61.2% of respondents, whereas only 38.3% correctly identified reduced work capacity and 29.5% identified adverse pregnancy outcomes as consequences of anemia. Female sex, higher educational status, higher socio-economic class, and prior exposure to health education were significantly associated with good knowledge (p<0.05). Television and healthcare workers were the most common sources of information.  Conclusion: A substantial proportion of adults in this community had inadequate knowledge and awareness of anemia and its consequences, particularly regarding its long-term health and functional effects. Targeted, multi-channel health education strategies focusing on low-literacy and low socio-economic groups are recommended to strengthen community-level anemia control efforts.

Background and aim of the study: Although mitral stenosis has profound effects on the circulation and hemodynamics, few data exist regarding its impact on aortic elastic properties. The study aim was to determine the association between mitral stenosis and aortic elastic properties by using strain and distensibility as a surrogate.

Methods: Sixty-six patients with echocardiographic documentation of rheumatic mitral stenosis, and 25 age- and gender-matched healthy control subjects were enrolled in the study. Aortic elasticity parameters including strain and distensibility were measured by means of echocardiography.

Results: The mean age of the patient and control groups were 41.8 +/- 12.0 and 38.9 +/- 5.0 years, respectively (p = 0.12). There was a significant impairment in distensibility and strain in the patient group compared to controls (0.276 +/- 0.167 versus 0.491 +/- 0.260 cm2 x dyn(-1), p = 0.001; 6.54 +/- 3.18% versus 9.19 +/- 4.78%, p = 0.015). There was a strong correlation between distensibility and left atrial diameter (p < 0.001; r = -0.39), left atrial volume index (p < 0.001; r = -0.56), mitral valve area (p < 0.001; r = 0.40), and mean transmitral gradient (p = 0.022; r = -0.18). Strain was also associated with left atrial diameter (p = 0.002; r = -0.32), left atrial volume index (p < 0.001; r = -0.41), mitral valve area (p = 0.002; r = 0.31), and mean transmitral gradient (p = 0.035; r = -0.18).

Conclusion: Mitral stenosis was shown to be associated with impaired aortic elasticity, but further studies are required to clarify the clinical significance of this finding.

Introduction: Thyroid disorders and diabetes are interrelated endocrine conditions. Individuals suffering from either disorder are at a significantly increased risk for the development of the alternate condition. Materials and Methods: A cross-sectional observational study was conducted to evaluate the association between Type 2 Diabetes Mellitus (T2DM) and hypothyroidism. Demographic and clinical information was systematically gathered through the utilization of a structured questionnaire, in conjunction with patient medical records. The variables encompassed age, gender, the duration of diabetes, and the history of complications associated with diabetes. Venous blood samples were obtained following an overnight fasting period. Subsequently, fasting blood sugar (FBS), postprandial blood sugar (PBS), and a thyroid function profile were conducted. The analysis of the data was conducted utilizing the Statistical Package for the Social Sciences (SPSS), version 20.0. Results: The study included a total of 108 participants. The predominant age demographic within the population is between 41 and 60 years, with the 51–60 age cohort representing the largest segment, consisting of 40 individuals, or 37.03% of the overall population. A substantial proportion of individuals exhibit HbA1c levels exceeding 8, underscoring a notable issue regarding insufficient diabetes management within this population. A significant segment of the population is presently exhibiting initial indicators of renal dysfunction. Diabetic neuropathy emerged as the most prevalent complication, affecting 39 individuals, which constitutes 36.11% of the cohort. Conclusion: Regular assessments of diabetes mellitus should be conducted in patients with hypothyroidism to facilitate early diagnosis, ensure optimal treatment, and prevent complications.

Background: Dengue fever is a rapidly emerging viral infection in tropical and subtropical regions, characterized by a broad clinical spectrum ranging from mild febrile illness to life-threatening complications. Recognizing its clinical manifestations and complication trends is essential for timely diagnosis and effective management. Objectives: To evaluate the clinical presentations and complication trends among patients diagnosed with dengue fever admitted to a tertiary care hospital. Methods: A total of 150 patients with laboratory-confirmed dengue and one or more warning signs were enrolled. Patients with co-infections or pre-existing comorbidities were excluded. Detailed clinical history, physical examination, and relevant investigations were performed. Complications were documented based on clinical and diagnostic findings. Results: Fever was the most common symptom (99.5%), followed by myalgia (70.4%), headache (46.4%), vomiting (43.2%), and abdominal pain (33.6%). Other notable symptoms included skin rash (25.6%), petechiae (19.2%), and altered sensorium (10.3%). Hemorrhagicmanifestations such as hematuria, malena, hematemesis, and epistaxis were observed in a minority of cases. Among the 150 patients, major complications included dengue with ARDS (38.8%), pleural effusion (33.3%), dengue encephalopathy (16.6%), and dengue-associated pneumonia (11.1%) Conclusion: Dengue fever continues to pose significant clinical challenges due to its varied presentations and potential for severe complications. Respiratory and neurological involvements are prominent among hospitalized patients. Early identification of warning signs and complications is crucial for effective management and improving patient outcomes in endemic settings.

Background: Adolescence is a critical window for growth and brain development. In rural settings, poverty, food insecurity, and limited health services heighten risks of undernutrition and anemia. Adolescence (10–19 years) is marked by rapid linear growth, peak accretion of bone mass, and increased iron requirements due to blood volume expansion and, in girls, menstruation. Rural adolescents often face compounded risks: seasonal food insecurity; reliance on cereal-based diets; limited access to health care, sanitation, and quality education; and sociocultural norms that may restrict dietary diversity or mobility. Anemia remains one of the most prevalent and preventable conditions affecting this age group and is a tracer of broader nutritional inequity. This study is targeted to find out the anemia prevalence of adolescents in rural adolescents. Studies were done in rural areas of India on anemia prevalence these studies reveal the actual prevalence of anemia and malnutrition among adolescents in the rural areas. The purpose of this study is therefore to determine the nutritional status and prevalence of anemia in rural adolescents.  Methods: Five hundred and eight rural adolescent school going and non-school going living in villages around SIMS, Hapur of age 10 to 19 years of both sexes were chosen by systemic random sampling. Migration populations were excluded from the study.  Results: Among 24 Villages, of which 20 Camps were conducted and 508 Adolescents were included. The non-school going constituted 8.27% among male and 27.39% among female. Among the school going males were 42.2% and female were 30.5%. Among male, in the school going group, 33.96% in early, 36.14% of middle and 43.94% of late adolescents were under nourished, whereas in non-school going male, 50% in early, 58.33% of middle and 20% of late adolescents were under nourished. In case of female adolescent, in the school going group, 49.18% in early, 20.59% of middle and 18.42% of late adolescents were under nourished whereas in non-school going female, 14.29% in early, 36.84% of middle and 45.95% of late adolescents were under nourished. Stunting is more common among boys from 10 years of age to 14 years of age than girls. After 14 years of age stunting is more common in girls than boys. The average stunting was 46.18% in male and to 48.1% in females.  Conclusions: Under nutrition was found to be a significant problem in both sexes of rural adolescents. Late adolescents were more undernourished in both sexes. Under nutrition was more common in boys than in girls. Anemia was more common in female than in male in both school going and non-school going. Anemia was more common in non-school going than in school going in both sexes. Severe anemia was more common in female of non-school going group.

Malleolar fractures are the most prevalent type of major fracture to occur in the lower extremities. Because the entire body weight is carried through the ankle, as well as the fact that movement is dependent on the stability of the ankle, these injuries take on a greater level of significance. Because these operative methods restore the anatomy, biomechanics, and contact loading characteristics of the ankle, open reduction and internal fixation have become the mainstay treatment for the majority of unstable bimalleolar fractures. This is because open reduction allows for more bone to be removed during the procedure.