Background and aims:  Pain on injection of propofol is a well-known side effect faced by all anesthesiologists in their day-to-day practice. The aim of the study was to assess the efficacy of low dose ketamine in the prevention of pain on injection of propofol.  Materials and methods: A prospective, randomized, and double-blind study was conducted on 100 patients, from either gender, aged 20-50 years, of the American Society of Anaesthesiologists Grade I or II, scheduled for various surgeries under general anesthesia. The patients were randomly divided into two groups of 50 each to receive either ketamine 0.5 mg/kg (Group K) or saline (Group S) infusion over 10 min. Venous drainage was occluded manually for one minute. This was followed by an injection of propofol 2 mg/kg IV over 25s. The patients were asked for pain on injection every 5s until the loss of consciousness. The pain scoring was done using McCririck and Hunter scale. The primary outcome of the study was the incidence of pain on propofol injection. Secondary outcomes such as increased secretions, emergence agitation were recorded.  Results:  Nine patients in group K (18%) and 42 patients in group S (84%) developed pain on injection of propofol. The incidence of pain was statistically significant between the two groups (p = < 0.001). Three patients in group K (6%) and 23 (46%) patients in group S had severe pain (p = < 0.001). Three patients in group K experienced increased secretions, which was not significant in comparison with the other group (6% vs 0%, p = 0.242). Four patients in group K had emergence agitation, but this was again not statistically significant when compared to group S (8% vs 0%, p = 0.117).  Conclusion:  We conclude that pretreatment of a smaller dose of ketamine was effective in the prevention of pain on injection of propofol without major side effects.

Introduction: Worldwide, the frequency of pregnancy complicated by maternal heart disease does not appear to have changed over the years, with overall prevalence of less than 0.1 to 4%. Cardiac disease in a pregnancy is a high-risk pregnancy which possess a significant challenge to an obstetrician. Cardiac disease in pregnancy is broadly divided into congenital and acquired. The acquired group includes rheumatic heart disease (RHD), cardiomyopathies and ischemic heart disease. Of these, in developing countries rheumatic heart disease is the commonest type, whereas cardiomyopathies and congenital heart disease one more common in developed countries.  Materials and Methods: This was a hospital based prospective observational study that include 130 pregnant women booked or non-booked, who were admitted in the Department of OBG, Ballari Medical College and Research Centre, Bellary with diagnosed cardiac disease or had symptoms and signs suggestive of cardiac disease which were later confirmed by relevant investigations during the study period of January 2024 to December 2024. Results: The present study consisted of 130 pregnant patients during the study period of January 2024 to December 2024. (Table 1) presents demographic data of the patients. In our study, the mean age of the patients was 24.33±2.93 years (ranging from 19-36 years). Most commonly affected age group was 21-25 years (64.62%) followed by age group 26-30 years (23.08%). 68 patients (52.30%) were primigravida, while the 32 patients (24.62%) were gravida 2, remaining 30 cases (23.07%) were gravida 3 and more. Mean gestational age at delivery was 37.46±2.14 weeks. Majority patients (70.77%) are present between 37-40 weeks of gestational age. Majority (58.46%) cases were from rural area. Out of 130 patients, 56 patients (41.54%) were booked while 76 patients (58.46%) were unbooked. Most unbooked patients are from rural area. Most of patients had vaginal delivery (64.62%) with spontaneous onset in 70 patients (53.85%) and induced in 14 cases (10.78%). Conclusion: In conclusion, the results of the present study suggest that management of the pregnant women with cardiac abnormalities should be multidisciplinary to enhance care for these patients. There is need for pre-pregnancy counseling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome. It is mandatory to provide better health care facilities to rural and periphery areas for diagnosis and management and early referral in such pregnant to prevent morbidity and mortality.

Introduction: Covid-19 caused by the novel SARS CoV2 is a devastating pandemic of the twenty-first century. As early as 2019, with the first case reports from Wuhan, China, it was found that the mortality parameters varied from region to region and was influenced by geographical and ethnic factors. Age, comorbidities, cultural and socio-economic factors influenced the outcome in severe COVID-19 infection.1 Earlier reported studies showed wide variability in the mortality rate across regions, and it varied from 1% to 12% in different geographical areas. Studies have shown that elderly patients and those with comorbidities like diabetes and hypertension had higher mortality. Materials and Methods: The study was conducted at Department of General Medicine, Jawaharlal Nehru Medical College (KLE University), Belagavi. A retrospective study was conducted for a period of six months from September 2020 to February 2021. All continuous samples which satisfy inclusion criteria were taken for study. All clinically suspected patients tested positive for COVID-19 by RT PCR were included in the study. Insufficient reported data information of COVID-19 patients excluded from the study. Nasal and oropharyngeal swabs (of clinically suspected COVID-19 patients) sent in viral transport media (VTM ) in cold chain to the Department of Microbiology, Molecular laboratory SSIMS and RC, Davangere was immediately tested for COVID-19 RT-PCR qualitative assay on Quant-studio Real-time thermocycler system. The CT (cycle threshold cut-off) value and amplification curve were observed and the result was expressed as positive or negative. All required details of RTPCR positive COVID-19 patients admitted in COVID care Centre i.e Demographic characters, comorbid conditions, clinical features, laboratory tests, radiological reports, treatment and outcome data were extracted from the hospital medical records section and analyzed. Results: Data from 684 RTPCR positive COVID-19 patients admitted to COVID care Centre BMCH were analyzed in our study retrospectively. The mean age of all patients was 38.9 years (± 12.5 SD). 340(49.6%) patients were between 18-45years, 240 (35.1%) were between 46-60 years and 104(15.2%) were aged above 60 years. Males (59.3%) were higher than females (40.6%). No comorbidities were observed in 502(73.3%) patients. Co-morbidities of the patients observed are Hypertension in 134(19.5%), diabetes in 119 (17.3%), COPD in 42(6.1%), chronic kidney disease in 17 (2.4%) and chronic liver disease in 9 (1.3%) patients. Of the 684 COVID-19 patients, 361(52.9%) were asymptomatic, 322(47.2%) were symptomatic, 144 (21.1%) patients had intensive care unit (ICU) admission, 542(79.2%) cured from COVID-19 and discharged and 95(13.6%) cases had mortality. Conclusion: Our study findings demonstrated that asymptomatic COVID-19 patients have better outcomes than symptomatic patients. This may have been due to more active cellular immune responses and normal liver function. Since asymptomatic patients have no clinical symptoms which can easily prevent timely diagnosis and treatment, they may cause a greater risk of virus transmission than symptomatic patients, which poses a major challenge to infection control. Patients with comorbidities were more vulnerable to disease severity and critical condition.

Introduction: Hypertension is a major public health problem all over the world. As India is progressing towards industrialization and improved mechanization, it has led people towards decreased work load and increased sedentary lifestyle. This has resulted in a rising trend of chronic lifestyle diseases like Hypertension (HTN), Diabetes Mellitus and Obesity. The incidence of hypertension is increasing year after year and the prevalence of hypertension is increasing day by day due to increased life expectancy and aging population. Materials and Methods: This study was approved by the Institutional review board and Institutional ethics committee and was conducted from January 2024 to December 2024 at the Department of General Medicine, S.S. Institute of Medical Science & Research Center, Davangere. It was a hospital-based cross-sectional study done among non-diabetic essential hypertensive in-patients with blood pressure above 140/90 mm of Hg and aged more than 30 years of either gender and admitted in general medicine ward of a tertiary care teaching institution in South India. Unwilling patients, diabetic patients, patients with renal disease, heart failure, macroalbuminuria and those with a positive history or clinical signs of ischaemic heart disease were excluded from the study.  Results: During the eight months, 186 patients who were admitted for various reasons and had a blood pressure reading above 140/90 mm of Hg were enrolled for the study after careful analysis of the exclusion criteria. Most of them were above 50 years and the mean age of the group studied was 55 ± 8.89 years. Of this, the mean age in the males was 56.6 + 8.9 years and that of the females was 52.6 + 7.0 years. The majority of the cases with microalbuminuria was found in the higher age group, 59.75 ± 16.32 years in males versus 57.9 ± 17.58 years in females. There was male sex preponderance in our study with 65 % (120 patients) of them being males and 35 % (66 patients) females. Conclusion: Most of microalbuminuria positive cases were found appropriated among higher ages. In this study, gender didn't represent a more serious danger for microalbuminuria. There was a huge measurable affiliation present between the microalbuminuria and span and the seriousness of hypertension. There is also a huge measurable affiliation present between microalbuminuria and target organ damage like LVH and retinopathy in hypertensive patients.

Background: Endobronchial tuberculosis (EBTB) is a specific form of pulmonary tuberculosis that involves the tracheobronchial tree and may lead to complications such as bronchial stenosis despite adequate anti-tubercular therapy (ATT). Corticosteroids, due to their anti-inflammatory properties, have been proposed as adjuncts to minimize such sequelae. This study aims to evaluate the efficacy of adjunctive corticosteroid therapy in improving clinical and radiological outcomes in EBTB patients. Materials and Methods: A prospective, randomized, controlled clinical study was conducted involving 60 newly diagnosed EBTB patients at a tertiary care center. Participants were randomly assigned into two groups: Group A received standard ATT alone, while Group B received ATT along with oral prednisolone (1 mg/kg/day tapered over 6 weeks). Patients were followed up for 3 months and assessed for symptom resolution (cough, dyspnea), radiological improvement, and incidence of bronchial stenosis via bronchoscopy. Data were analyzed using SPSS version 26 with a significance threshold of p<0.05. Results: By the end of the 12-week follow-up, 83.3% of patients in Group B showed complete symptom resolution compared to 63.3% in Group A (p=0.048). Radiological improvement was observed in 76.7% of the corticosteroid group versus 56.7% in the control group (p=0.041). Bronchial stenosis developed in 10% of Group B patients, significantly lower than the 30% observed in Group A (p=0.032). No major corticosteroid-related adverse events were reported. Conclusion: The addition of corticosteroids to conventional anti-tubercular therapy in patients with endobronchial tuberculosis significantly improves clinical and radiological outcomes and reduces the risk of bronchial stenosis. This suggests that corticosteroids are a beneficial adjunct in managing EBTB

Background: post-myocardial infarction (MI) management often focuses on optimizing left ventricular ejection fraction (LVEF) to prevent heart failure and improve prognosis. Enhanced External Counterpulsation (EECP) and Enhanced Myocardial Salvage and Repair (EMSR) therapies have emerged as non-invasive modalities aimed at myocardial perfusion enhancement and tissue recovery. This study compares the efficacy of EECP and EMSR in improving LVEF in patients recovering from acute MI. Materials and Methods: A single-center, randomized controlled trial was conducted involving 60 post-MI patients aged 45–70 years with baseline LVEF between 30–50%. Patients were randomly assigned into two groups: Group A (n=30) received EECP therapy (1-hour sessions, 5 days/week for 6 weeks), while Group B (n=30) underwent EMSR therapy involving advanced metabolic and regenerative interventions over the same period. Echocardiographic assessment of LVEF was performed at baseline and 8 weeks post-intervention. Secondary outcomes included changes in NYHA classification and 6-minute walk distance (6MWD). Data were analyzed using paired and independent t-tests with a significance level set at p<0.05. Results: Baseline characteristics between the groups were comparable (p>0.05). Post-intervention, Group A showed a mean LVEF improvement from 38.2% ± 5.1% to 45.3% ± 4.6% (p=0.003), while Group B demonstrated a greater increase from 37.9% ± 4.8% to 49.1% ± 5.2% (p<0.001). The intergroup difference in LVEF improvement was statistically significant (p=0.021). Additionally, Group B exhibited a more pronounced enhancement in 6MWD (mean increase of 76.5 m vs 52.1 m in Group A) and better NYHA class improvement. Conclusion: Both EECP and EMSR therapies significantly improved LVEF in post-MI patients. However, EMSR showed superior efficacy in enhancing cardiac function and functional capacity. These findings suggest EMSR may be a more effective adjunctive modality in myocardial recovery post-infarction.

Background: Refractory heart failure (RHF) continues to pose a therapeutic challenge, with limited options for patients unresponsive to guideline-directed medical therapy. Enhanced External Counterpulsation (EECP) and External Myocardial Synchronous Reconditioning (EMSR) have emerged as non-invasive adjunctive interventions aimed at improving myocardial perfusion and function.  Materials and Methods: A total of 120 patients with NYHA class III-IV RHF were enrolled across four tertiary care centers. Patients were randomized into two equal groups: EECP (n=60) and EMSR (n=60). The interventions were administered over 35 sessions spanning 7 weeks. Biomarkers such as NT-proBNP, high-sensitivity cardiac troponin I (hs-cTnI), and galectin-3 were measured at baseline, post-therapy, and at 3-month follow-up. Imaging assessments included echocardiography (EF, LVEDD, LVESD), cardiac strain analysis, and cardiac MRI (in selected cases) to evaluate structural and functional recovery. Statistical analysis involved paired and unpaired t-tests, with p<0.05 considered significant. Results: Post-intervention, the EECP group showed a significant reduction in NT-proBNP levels (mean reduction: 420 ± 75 pg/mL; p<0.001), compared to EMSR (mean reduction: 310 ± 65 pg/mL; p<0.01). LVEF improved significantly in both groups (EECP: +8.5 ± 2.1%, EMSR: +6.3 ± 1.9%; p=0.04). Myocardial strain improved more in the EECP group (-2.8 ± 0.7% vs -1.9 ± 0.6%, p=0.03). Galectin-3 levels decreased by 21% in EECP and 15% in EMSR, both statistically significant. MRI findings indicated better perfusion recovery in the EECP arm in 60% of evaluated patients. No major adverse effects were reported in either group. Conclusion: Both EECP and EMSR significantly improve myocardial biomarkers and imaging-based parameters in patients with refractory heart failure. However, EECP demonstrates superior efficacy in enhancing myocardial recovery, particularly in terms of biomarker suppression and functional imaging outcomes. These findings support the preferential consideration of EECP in appropriate RHF patient subsets.

Background: Regular physical activity is known to positively influence pulmonary function, while sedentary behavior may contribute to declining respiratory health. This study aims to compare spirometric and gas exchange parameters between sedentary and physically active adults to assess the impact of lifestyle on pulmonary performance. Materials and Methods: A cross-sectional comparative study was conducted on 60 adults aged 20–40 years, divided into two groups: sedentary (n=30) and physically active individuals (n=30). Participants in the active group reported engaging in at least 150 minutes of moderate-intensity physical activity per week. Pulmonary function was assessed using standard spirometry (parameters included FVC, FEV₁, FEV₁/FVC ratio, and PEFR) and gas exchange analysis (VO₂ max and oxygen saturation levels at rest and post-exercise). Data were statistically analyzed using independent t-tests, with significance set at p<0.05. Results: The physically active group showed significantly higher mean values for FVC (4.3 ± 0.5 L vs. 3.6 ± 0.4 L), FEV₁ (3.5 ± 0.4 L vs. 2.9 ± 0.3 L), and PEFR (8.2 ± 0.9 L/s vs. 6.7 ± 0.8 L/s) compared to the sedentary group (p<0.01). VO₂ max was also higher in the active group (43.5 ± 5.2 ml/kg/min) than in sedentary participants (31.7 ± 4.8 ml/kg/min). Post-exercise oxygen saturation remained stable in active individuals (96.8% ± 1.2%) but showed a slight decline in the sedentary group (94.2% ± 1.5%). Conclusion: Physically active individuals demonstrated superior pulmonary function and gas exchange efficiency compared to their sedentary counterparts. These findings reinforce the respiratory benefits of maintaining an active lifestyle and highlight the need for public health initiatives promoting physical activity.

Background: Sedentary lifestyles have been increasingly associated with metabolic disturbances, including impaired glucose regulation. This study aimed to compare fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) levels in sedentary and physically active young adults to assess the impact of physical activity on glycemic control. Materials and Methods: A cross-sectional study was conducted involving 100 young adults aged 18–25 years, categorized into two groups: sedentary (n=50) and physically active (n=50), based on the International Physical Activity Questionnaire (IPAQ). Fasting blood samples were collected to assess FBG using the glucose oxidase method and HbA1c using high-performance liquid chromatography (HPLC). Statistical analysis was performed using an independent samples t-test to evaluate differences between the two groups. Results: The mean FBG level in the sedentary group was 96.4 ± 8.2 mg/dL, while in the physically active group it was 88.1 ± 7.6 mg/dL (p < 0.001). The mean HbA1c in the sedentary group was 5.7 ± 0.3%, compared to 5.3 ± 0.2% in the active group (p < 0.001). A significant negative correlation (r = -0.42; p < 0.01) was observed between physical activity levels and both glycemic markers. Conclusion: Young adults who engage in regular physical activity demonstrate significantly lower fasting blood glucose and HbA1c levels compared to their sedentary peers. Promoting active lifestyles among youth may contribute to better long-term glycemic control and reduced risk of metabolic disorders.

Background: Early diagnosis of myocardial infarction (MI) in postmortem cases is challenging, especially in the absence of clear histological evidence. Biochemical markers such as cardiac troponins and creatine kinase-MB (CK-MB) have been extensively studied in postmortem serum, but their evaluation in alternative body fluids like vitreous humor and pericardial fluid remains limited. This study aims to compare the diagnostic utility of these two fluids for early MI detection using specific biochemical markers. Materials and Methods: A total of 60 autopsy cases were included in this prospective comparative study conducted in a tertiary forensic institute over 18 months. Cases were divided into two groups: Group A (MI-confirmed, n=30) and Group B (non-cardiac deaths, n=30). Vitreous humor and pericardial fluid were collected within 12 hours postmortem. Cardiac Troponin I (cTnI), CK-MB, and Lactate Dehydrogenase (LDH) levels were quantified using chemiluminescent immunoassay techniques. Statistical analysis was conducted using SPSS v25 with significance set at p<0.05. Results: Mean cTnI levels in Group A were significantly elevated in both vitreous humor (3.5 ± 1.2 ng/mL) and pericardial fluid (6.8 ± 1.9 ng/mL) compared to Group B (vitreous: 0.9 ± 0.3 ng/mL; pericardial: 1.2 ± 0.4 ng/mL; p<0.001). CK-MB and LDH also showed significantly higher levels in MI cases, particularly in pericardial fluid. ROC analysis revealed that cTnI in pericardial fluid had the highest diagnostic accuracy (AUC = 0.93), followed by cTnI in vitreous humor (AUC = 0.87). Conclusion: Both vitreous humor and pericardial fluid are reliable alternative matrices for postmortem biochemical detection of early myocardial infarction. However, pericardial fluid demonstrates superior diagnostic performance, particularly for cardiac troponin I. These findings support the integration of biochemical analysis of alternative fluids in forensic investigations of sudden cardiac deaths.

Background: Scrub typhus is an infection transmitted by mites, caused by the bacterium Orientia tsutsugamushi, and is a significant contributor to acute febrile illnesses in the Asian population. The median mortality rate for untreated scrub typhus is 6%, which decreases to 1.4% with appropriate treatment. The condition typically manifests as an acute febrile illness accompanied by symptoms such as headache, cough, shortness of breath, and altered mental status. A notable diagnostic indicator is the presence of an eschar at the site of the mite bite. Severe cases can arise in one-third of hospitalized patients, potentially resulting in multiorgan dysfunction, shock, and death in approximately 25% of cases, even with treatment. Historically, chloramphenicol was used for treatment, but its use declined due to toxicity concerns. Research has explored the efficacy of alternative medications, with some studies indicating that a single dose of 500 mg azithromycin is as effective as a week-long course of 200 mg doxycycline. Aim And Objectives: To compare the effectiveness of single dose of 500 mg azithromycin to a week-long course of 200 mg doxycycline in a patient with scrub typhus. Materials And Methods: This investigation was conducted on 30 pediatric patients, all aged 12 years or younger, who experienced a fever for a minimum of one week and tested positive for Scrub typhus through IgM ELISA. The treatment regimen included either Azithromycin (10 mg/kg taken orally once daily for seven days) or Doxycycline (for children weighing 40 kg: 100 mg given twice daily for seven days). The study did not include children who had been treated with antibiotics prior to diagnosis or those who were noncompliant with their treatment. Results: Mean age of study population was 6.74 years. Adverse reactions were observed in 3 patients in azithromycin group and none of the patients in doxycycline group have reported adverse reactions. Conclusion: Doxycycline has proven to be more effective in achieving fever reduction and in preventing negative drug reactions in individuals with Scrub typhus.

Background: Infertility is a major public health problem worldwide that has been encountered more during recent years. It seems to be affected by changes in familial condition and tendency to marriage, having child in higher age, more excessive use of contraception methods, illegal abortion, and unfavorable socioeconomic condition, agents related to climate and geographic areas and perhaps genetic diversity. Aim:  To evaluate the anatomical causes of primary infertility in couple. To evaluate the pathophysiological causes of primary infertility in males and females Method and Material: The study was conducted on 200 couples in Index Medical College and Research Centre and Manipal Ankur Center for infertility CHL hospital Indore. Subjects with the complaint of primary infertility in the child bearing age span had provided the necessary clinical material for this study. With routine investigation special investigation were done like HSG and Semen analysis was done. Result: In the present study, primary infertility was seen in 31.79% in males and 68.21% in female. Etiological factors in female for primary infertility were 49.63% having tubal blockage, 12.04% endometriosis, 6.77% Arcuate uterus, 6.02% septate uterus. Etiological factors in male were 41.94% azoospermia, 29.03% oligospermia, 11.29% asthenospermia and 6.45% aspermia. Conclusion: Prevalence of primary infertility is predominant in female compared to males. The most common cause of primary infertility in female was tubal blockage and in male was azoospermia.

Background: Chronic kidney disease (CKD) significantly increases the risk of cardiovascular disease (CVD), which remains the leading cause of morbidity and mortality in this population. Traditional cardiac biomarkers may be less reliable in CKD patients due to altered clearance and chronic inflammation. High-sensitivity cardiac troponin (hs-cTn), a sensitive and specific biomarker of myocardial injury, has emerged as a potential predictor of cardiovascular events, even in the absence of acute coronary syndrome. This study aimed to assess the prognostic value of hs-cTn in predicting future cardiovascular events among patients with varying stages of CKD. Materials and Methods: A total of 150 CKD patients (Stages 3–5) without a history of recent myocardial infarction were enrolled. Baseline levels of hs-cTnT were measured using a high-sensitivity immunoassay. Participants were followed for the occurrence of major adverse cardiovascular events (MACE), including myocardial infarction, stroke, heart failure hospitalization, and cardiovascular death. Patients were stratified into three groups based on hs-cTnT tertiles: Low (<10 ng/L), Intermediate (10–25 ng/L), and High (>25 ng/L). Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate the association between hs-cTnT levels and MACE. Results: During the follow-up period, 42 patients (28%) experienced at least one cardiovascular event. The incidence of MACE was significantly higher in the high hs-cTnT group (46%) compared to the intermediate (24%) and low (14%) groups (p < 0.01). Cox regression analysis showed that patients in the high hs-cTnT group had a 3.4-fold increased risk of MACE (HR 3.4; 95% CI 1.9–6.1, p < 0.001) after adjusting for age, diabetes, hypertension, and eGFR. Kaplan-Meier analysis demonstrated significantly reduced event-free survival in the high hs-cTnT group (log-rank p < 0.001). Conclusion: High-sensitivity cardiac troponin is a strong and independent predictor of cardiovascular events in CKD patients. Its routine use in risk stratification may enhance early identification of high-risk individuals and enable timely intervention. Further large-scale studies are warranted to establish standardized hs-cTnT thresholds in the CKD population

Background: Mental health disorders, particularly depression and anxiety, are highly prevalent yet often underdiagnosed in primary care settings. Traditional screening practices are time-intensive and may be inconsistently applied. Digital cognitive tools offer an innovative solution for early identification, standardization, and improved integration of mental health services into routine primary care. This pilot study aimed to evaluate the feasibility and preliminary outcomes of a digital mental health screening tool implemented in a primary care clinic. Materials and Methods A cross-sectional pilot program was conducted in a metropolitan primary care clinic over a period of six months. A total of 250 adult patients aged 18–65 years attending routine consultations were invited to participate. Participants completed a digital screening tool incorporating standardized questionnaires: the PHQ-9 for depression, GAD-7 for anxiety, and a brief cognitive assessment (MoCA-short). The tool was administered via tablet prior to the physician consultation. Outcomes measured included screening completion rate, positive screen prevalence, average time to completion, physician follow-up adherence, and patient satisfaction. Data were analyzed using descriptive and inferential statistics (Chi-square and t-tests, p < 0.05 considered significant). Results Of the 250 patients, 230 (92%) completed the digital screening. The mean completion time was 7.2 ± 2.1 minutes. Positive screening rates were 26% for moderate-to-severe depression (PHQ-9 ≥10), 18% for anxiety (GAD-7 ≥10), and 12% showed signs of cognitive impairment (MoCA-short <22). Follow-up referral adherence by primary care providers was 84% for positive cases. Patient satisfaction with the digital screening was high, with 88% rating it as helpful and 91% reporting ease of use. Conclusion The integration of a digital mental health screening tool in primary care is both feasible and effective in identifying at-risk individuals. High completion and satisfaction rates, along with timely follow-up, suggest that such tools can support early intervention and streamline mental health service delivery. Further large-scale studies are recommended to assess clinical outcomes and long-term impact.

Background: Metabolic Syndrome (MetS) represents a growing public health challenge, especially in rapidly urbanizing populations. Sedentary lifestyle, unhealthy diet, and psychosocial stress contribute significantly to its rising prevalence. This study aimed to assess the effectiveness of a structured multisectoral lifestyle modification program in reducing the prevalence and severity of MetS in an urban population. Materials and Methods: This community-based, quasi-experimental trial was conducted over 12 months in two urban localities. A total of 300 adults aged 30–60 years diagnosed with MetS (as per NCEP ATP III criteria) were enrolled and randomized into intervention (n = 150) and control (n = 150) groups. The intervention group received a comprehensive program that included dietary counseling by nutritionists, physical activity sessions led by fitness trainers, stress reduction workshops, and periodic health education through local municipal partnerships. Anthropometric, biochemical, and lifestyle data were recorded at baseline and at the end of the intervention. Primary outcomes included changes in waist circumference, fasting blood glucose, triglycerides, HDL cholesterol, and blood pressure. Statistical analysis was performed using paired and unpaired t-tests, with p < 0.05 considered significant. Results: At the end of 12 months, significant improvements were observed in the intervention group compared to controls. Mean waist circumference reduced by 5.8 cm (p = 0.001), fasting glucose by 14.2 mg/dL (p = 0.002), triglycerides by 28.4 mg/dL (p = 0.003), and systolic blood pressure by 11.6 mmHg (p = 0.004). HDL cholesterol showed a modest increase of 3.1 mg/dL (p = 0.048). The prevalence of MetS decreased from 100% to 64% in the intervention group, while it remained unchanged (98%) in the control group. Conclusion: A coordinated, multisectoral lifestyle modification intervention delivered at the community level can significantly improve metabolic parameters and reduce the burden of MetS in urban populations. These findings highlight the potential of integrated public health approaches in managing non-communicable diseases.

Background: clinical challenge in diabetic patients. The co-existence of chronic kidney disease and cardiovascular dysfunction worsens prognosis, increases hospitalization, and elevates mortality risk. Early detection using biomarkers and imaging modalities like echocardiography may help predict progression and facilitate timely intervention. This longitudinal study aimed to evaluate the development and progression of CRS in diabetic patients through serial assessments of biomarkers and echocardiographic parameters. Materials and Methods A prospective longitudinal study was conducted over 18 months at a tertiary care center, involving 120 adult patients with type 2 diabetes mellitus. Patients with known structural heart disease or advanced renal failure (eGFR <30 mL/min/1.73 m²) were excluded. Participants underwent clinical evaluations, biomarker testing [NT-proBNP, cystatin C, serum creatinine, eGFR], and transthoracic echocardiography at baseline, 9 months, and 18 months. Left ventricular ejection fraction (LVEF), diastolic function, and left atrial size were recorded. Progression to CRS was defined based on combined worsening of cardiac and renal parameters. Data were analyzed using repeated-measures ANOVA and Kaplan-Meier survival curves. Results Out of 120 patients enrolled, 108 completed the study. The incidence of newly diagnosed CRS over 18 months was 32.4%. A significant rise in NT-proBNP (from 186 ± 45 pg/mL to 325 ± 62 pg/mL; p < 0.001) and cystatin C (from 1.08 ± 0.14 mg/L to 1.36 ± 0.18 mg/L; p < 0.01) was observed in those who developed CRS. Echocardiographic assessment revealed a decline in LVEF (from 58.2% ± 4.1% to 52.3% ± 5.7%) and worsening of diastolic function in 28 patients. Kaplan-Meier analysis showed a significantly higher CRS incidence in patients with baseline NT-proBNP >250 pg/mL (p = 0.002). Conclusion The study highlights that diabetic patients are at considerable risk of developing cardiorenal syndrome over time. Elevated NT-proBNP and cystatin C levels, along with echocardiographic changes, serve as early indicators of CRS. Regular monitoring of cardiac and renal biomarkers, alongside imaging, is recommended for early identification and improved management of at-risk diabetic individuals.

Background: Type 2 Diabetes Mellitus (T2DM) is a systemic metabolic disorder with multisystem complications, though its impact on pulmonary function remains underrecognized. Chronic hyperglycemia is hypothesized to impair lung mechanics through advanced glycation end-products (AGEs) and microangiopathy.  Objective: This study evaluates pulmonary function tests (PFTs) and their association with glycemic control in T2DM patients in rural India, a region with limited healthcare access and high diabetes prevalence. Methods: A case-control study enrolled 424 T2DM patients (cases) and 424 age- and sex-matched controls. Participants aged 40–65 years underwent spirometry (measuring FVC, FEV1, FEV1/FVC, PEFR, FEF25–75%) and HbA1c testing via HPLC. Exclusion criteria included smoking, obesity (BMI >30 kg/m²), and respiratory/cardiovascular diseases. Statistical analyses included t-tests, ANOVA, Pearson’s correlation, and multivariate regression adjusting for age, BMI, and socioeconomic status (Kuppuswamy Scale). Result: T2DM patients exhibited significant reductions in FVC (2.38 vs. 3.08 L), FEV1 (1.85 vs. 2.51 L), and FEV1/FVC ratio (70.2% vs. 81.6%) compared to controls (p<0.001). Restrictive lung patterns dominated in diabetics (59% vs. 16.5%, p<0.001). HbA1c correlated inversely with all PFT parameters (r=-0.43 to -0.31, p<0.001), with poorest lung function in patients with HbA1c >8%. Socioeconomic disparities were evident: lower-income groups had worse glycemic control (47.2% HbA1c ≥7%) and reduced FVC (p<0.001). Males outperformed females in FVC (2.55 vs. 2.18 L) and FEV1 (1.98 vs. 1.70 L, p<0.001). Diabetes duration >10 years exacerbated pulmonary decline (FVC=2.20 L vs. 2.52 L in <5 years, p<0.001). Conclusion: T2DM significantly impairs pulmonary function, particularly under poor glycemic control. Restrictive patterns dominate, linked to AGE-mediated lung stiffening. Socioeconomic and gender disparities highlight the need for equitable healthcare interventions. Routine PFTs and integrated diabetes-respiratory care are recommended to mitigate extrapulmonary complications in high-risk populations.

Wearable technology for cardiac rhythm monitoring has rapidly emerged as a non-invasive, cost-effective, and scalable solution for the early detection, diagnosis, and management of arrhythmias. This systematic review aims to synthesize current literature on the clinical accuracy, usability, and limitations of wearable devices for cardiac rhythm assessment. A comprehensive search was conducted across PubMed, Scopus, and IEEE Xplore databases covering publications from January 2015 to April 2025. Inclusion criteria focused on studies evaluating smartwatches, chest straps, and wearable patches with electrocardiographic (ECG) or photoplethysmography (PPG) capabilities. Results demonstrate a growing body of evidence supporting the feasibility and accuracy of wearables in identifying atrial fibrillation, premature contractions, and heart rate variability. Devices such as the Apple Watch, Fitbit, and AliveCor KardiaMobile have shown promising sensitivity and specificity when compared to clinical gold standards. However, challenges remain in terms of motion artifacts, signal noise, regulatory approvals, and integration with clinical workflows. This review underscores the potential of wearable cardiac monitors in preventive cardiology and telehealth, while highlighting the need for standardization and long-term validation in diverse populations.

Background: Tuberculosis lymphadenitis (TBLN) is the most prevalent form of extrapulmonary tuberculosis, commonly affecting cervical lymph nodes. The clinical profile and treatment outcomes of TBLN vary across regions and healthcare settings. Early diagnosis and timely initiation of anti-tubercular therapy (ATT) are critical to improving prognosis and reducing morbidity. Materials and Methods: A prospective observational study was conducted over 18 months in the Department of General Medicine at a tertiary care hospital. A total of 120 patients with histopathologically or microbiologically confirmed TBLN were enrolled. Detailed demographic data, clinical presentations, site of lymphadenopathy, diagnostic modalities, and response to standard Category I ATT were documented. Follow-up was carried out at 2-, 4-, and 6-months post-treatment initiation to assess resolution and complications. Results: Among 120 patients, 78 (65%) were female and 42 (35%) males, with a mean age of 28.4 ± 11.2 years. The most common clinical feature was painless cervical lymphadenopathy (84.1%), followed by fever (60.8%), weight loss (47.5%), and night sweats (32.5%). Right-sided lymph node involvement was observed in 54 (45%) cases. FNAC was diagnostic in 72%, while excisional biopsy confirmed TBLN in the remaining. After 6 months of ATT, complete clinical resolution was achieved in 105 (87.5%) patients, partial response in 10 (8.3%), and recurrence in 5 (4.2%). Conclusion: Tuberculosis lymphadenitis presents predominantly in young females with cervical lymph node involvement. FNAC remains a valuable diagnostic tool, and standard ATT shows high efficacy in most cases. Timely intervention and adherence to treatment protocols ensure favorable outcomes, although a small proportion may exhibit recurrence or incomplete response

Background and aim of the study Differentiating physiological athlete's heart from arrhythmogenic right ventricular cardiomyopathy (ARVC) remains a complex challenge, particularly in asymptomatic young athletes. Early identification is crucial to prevent sudden cardiac death (SCD). Materials and methods We present a 15-year-old male footballer undergoing routine sports screening. Resting electrocardiogram (ECG) revealed isolated T-wave inversion in V1. Echocardiography showed mild right ventricular (RV) dilation. Cardiac magnetic resonance imaging (CMR) identified minor RV regional wall motion abnormalities and mildly reduced RV ejection fraction. No late gadolinium enhancement was observed. Holter monitoring and exercise testing demonstrated no ventricular arrhythmias. Cardiac biomarkers were normal. Results The findings fulfilled only one minor ARVC diagnostic criterion, insufficient for definitive diagnosis per 2010 Task Force and 2020 Padua criteria. Given the borderline phenotype, multidisciplinary evaluation and shared decision-making were employed. Exercise restriction and further investigations including genetic testing and serial imaging were advised. Conclusions This case illustrates the diagnostic ambiguity in suspected early ARVC in athletes. Comprehensive evaluation, cautious interpretation of borderline findings, and individualized management strategies are paramount to balancing athletic aspirations with safety.

Background: Polycystic Ovarian Syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Emerging evidence suggests a potential role of vitamin D in modulating reproductive and metabolic functions. This study aims to evaluate the association between serum vitamin D levels and patients diagnosed with PCOS. Materials and Methods: A cross-sectional study was conducted over six months involving 100 women aged 18–35 years. Fifty women diagnosed with PCOS based on the Rotterdam criteria formed the study group, while fifty age- and BMI-matched healthy women served as controls. Blood samples were collected to assess serum 25-hydroxyvitamin D [25(OH)D] levels using chemiluminescent immunoassay. Clinical features including body mass index (BMI), menstrual irregularities, acne, and hirsutism were recorded. Statistical analysis was performed using SPSS v25, with significance set at p < 0.05. Results: The mean serum vitamin D level in the PCOS group was 14.2 ± 4.8 ng/mL, significantly lower than the control group (22.5 ± 5.1 ng/mL) (p < 0.001). Among PCOS patients, 76% had vitamin D deficiency (<20 ng/mL), compared to 38% in the control group. A significant inverse correlation was observed between serum vitamin D levels and BMI (r = -0.52, p = 0.003) and Ferriman-Gallwey score (r = -0.46, p = 0.007) in the PCOS group. Conclusion: The findings indicate that women with PCOS are more likely to have lower serum vitamin D levels, which may contribute to the severity of clinical manifestations. Vitamin D assessment and correction may play a supportive role in the management of PCOS.

Introduction: Infertility is a major public health problem worldwide that has been encountered more during recent years. Infertility leads to considerable personal suffering and disruption of family life. According to United Nations “Reproductive health is a state of complete physical, mental and social wellbeing and not merely absence of the disease or infirmity in all matters related to the reproductive system and its functions and processes”3. The most comprehensive study of infertility Aim:  To evaluate the prevalence of male and female infertility in different age groups. Method and material: The study was conducted on 200 couples in Index Medical College and Research Centre and Manipal Ankur Center for infertility CHL hospital Indore. Subjects with the complaint of primary infertility in the child bearing age span had provided the necessary clinical material for this study. With routine investigation. Result: Age alone impacts on fertility, In the present study maximum number of infertile females (51.13%) belonged to the age group between 20 to 30 with mean age group 31.46 ± 4.99 years Conclusion: Prevalence of primary infertility is predominant in female compared to males. The age group affected in both the gender is 20-30years.

This study examines the relationship between emotional eating and obesity in an adult Indian population, addressing a gap in understanding how emotional eating influences BMI in culturally specific contexts. Utilizing the Emotional Eater Questionnaire (EEQ), we categorized 101 participants based on emotional eating tendencies and analyzed their association with obesity. Findings reveal that higher emotional eating scores are associated with increased BMI, suggesting that emotional eating plays a significant role in obesity risk among Indian adults.

Background: The COVID-19 pandemic significantly accelerated the adoption of telemedicine worldwide, especially for managing chronic diseases like hypertension. With the easing of pandemic-related restrictions, a comparative evaluation of the effectiveness of telemedicine versus traditional in-person consultations is essential to optimize long-term hypertension management strategies. Materials and Methods: A prospective, comparative study was conducted at a tertiary care center. A total of 200 patients diagnosed with primary hypertension were enrolled and randomized into two groups: Group A (n=100) received telemedicine consultations via video/audio calls every month, while Group B (n=100) attended in-person visits on the same schedule. Both groups received lifestyle counseling and medication adjustments based on their blood pressure (BP) readings. Data on systolic and diastolic BP, medication adherence (using the Morisky scale), and patient satisfaction (using a 5-point Likert scale) were collected at baseline and after 6 months. Results: At the end of the study period, Group A showed a mean reduction of 12.5 mmHg in systolic BP and 8.2 mmHg in diastolic BP, while Group B showed a reduction of 13.1 mmHg and 8.5 mmHg respectively. There was no statistically significant difference in BP control between the groups (p > 0.05). Medication adherence was slightly higher in the telemedicine group (mean Morisky score: 7.8 ± 1.1) compared to the in-person group (7.4 ± 1.3), though not statistically significant. Patient satisfaction was higher in the telemedicine group (mean score: 4.6/5) due to convenience and time-saving benefits. Conclusion: Telemedicine consultations were found to be as effective as in-person visits in managing hypertension in the post-COVID era, with comparable outcomes in BP control and adherence, and higher patient satisfaction. These findings support the integration of telehealth as a sustainable model for chronic disease management.

Background: Subclinical atherosclerosis (SA) is a silent yet progressive vascular complication in patients with Type 2 Diabetes Mellitus (T2DM), often going undetected until clinical manifestations occur. MicroRNAs (miRNAs), small non-coding RNA molecules that regulate gene expression, have emerged as promising non-invasive biomarkers for early vascular changes. This study aims to assess the diagnostic potential of specific circulating miRNAs in identifying SA in asymptomatic T2DM patients. Materials and Methods: A cross-sectional observational study was conducted involving 90 participants aged 40–65 years, divided into three groups: Group A (T2DM with SA, n=30), Group B (T2DM without SA, n=30), and Group C (healthy controls, n=30). Subclinical atherosclerosis was diagnosed using carotid intima-media thickness (CIMT) measurement via high-resolution B-mode ultrasonography. Circulating levels of miR-126, miR-146a, and miR-21 were quantified using real-time quantitative polymerase chain reaction (RT-qPCR). Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic accuracy of these miRNAs. Results: Mean CIMT values were significantly elevated in Group A (0.87 ± 0.09 mm) compared to Group B (0.63 ± 0.05 mm) and Group C (0.58 ± 0.06 mm) (p < 0.001). Levels of miR-126 and miR-146a were significantly downregulated in Group A (1.9 ± 0.6 and 2.2 ± 0.7-fold change, respectively) compared to Group B (3.5 ± 0.8 and 3.9 ± 1.0) and Group C (4.1 ± 0.9 and 4.3 ± 0.6). Conversely, miR-21 levels were upregulated in Group A (5.6 ± 1.2-fold change) vs. Group B (3.4 ± 0.9) and Group C (2.1 ± 0.5). ROC analysis revealed miR-126 had the highest area under the curve (AUC = 0.89), followed by miR-146a (AUC = 0.85) and miR-21 (AUC = 0.82), indicating good diagnostic performance. Conclusion: Altered expression of miR-126, miR-146a, and miR-21 in T2DM patients with subclinical atherosclerosis suggests their utility as early, non-invasive biomarkers for vascular risk stratification. Incorporating miRNA profiling into routine diabetic care may facilitate early detection and timely intervention for atherosclerotic complications.

Background: Hand hygiene remains the most effective measure in preventing hospital-acquired infections. Despite continuous training, compliance among healthcare providers, particularly medical interns, often falls short of expected standards. Understanding the adherence levels and influencing factors is essential for implementing effective interventions. Materials and Methods: A cross-sectional observational study was conducted over a 3-month period in a tertiary care teaching hospital. A total of 120 medical interns were included using convenience sampling. Hand hygiene practices were assessed through direct observation based on WHO’s “Five Moments for Hand Hygiene” guidelines. Compliance was measured during routine clinical duties using a structured checklist. Additional data were collected via a validated self-administered questionnaire assessing knowledge, attitude, and perceived barriers. Results: Overall hand hygiene compliance was observed to be 52.4%. Compliance was highest before aseptic procedures (67.1%) and lowest after touching patient surroundings (38.2%). Female interns showed significantly higher compliance (58.9%) than males (47.3%; p=0.03). Interns posted in the ICU had better adherence (61.5%) compared to those in general wards (46.2%). Knowledge scores were moderate (mean = 7.3 ± 1.5 out of 10), and 64% of participants cited lack of accessible hand rubs as a major barrier. Multivariate analysis revealed that knowledge score and departmental posting were significant predictors of compliance (p<0.05). Conclusion: Hand hygiene compliance among medical interns was suboptimal, with significant variation based on clinical context and gender. Targeted training programs, regular monitoring, and improved accessibility to hand hygiene facilities are recommended to enhance compliance and reduce nosocomial infection risks.

Background: Atrial fibrillation (AF) is a significant risk factor for stroke, especially in hypertensive individuals. The choice of antihypertensive therapy may influence cerebrovascular outcomes in these patients. Beta-blockers (BBs) and calcium channel blockers (CCBs) are frequently prescribed for rate control in AF, but their comparative effectiveness in preventing stroke remains uncertain. This study aims to evaluate the effectiveness of BBs versus CCBs in reducing the incidence of stroke among hypertensive patients with AF. Materials and Methods: A retrospective cohort study was conducted on 240 hypertensive patients with non-valvular AF attending a tertiary care hospital from January 2022 to December 2023. Patients were divided into two groups: Group A (n=120) received beta-blockers, and Group B (n=120) received calcium channel blockers. Baseline characteristics, blood pressure control, and stroke incidence were recorded over a 12-month follow-up. Stroke events were confirmed via neuroimaging. Statistical analysis was performed using the Chi-square test and Cox proportional hazards model to compare stroke risk between the groups. Results: The mean age of participants was 68.4 ± 9.2 years, with 56% males and 44% females. At the end of 12 months, stroke incidence was significantly lower in the BB group (8.3%) compared to the CCB group (15.8%) (p = 0.045). Multivariate analysis adjusted for age, sex, CHA₂DS₂-VASc score, and blood pressure control showed that beta-blocker therapy was associated with a 35% lower risk of stroke (HR = 0.65; 95% CI: 0.43–0.98). Conclusion: Beta-blockers demonstrated a modest but statistically significant advantage over calcium channel blockers in reducing stroke risk among hypertensive patients with atrial fibrillation. These findings support the preferential use of beta-blockers in patients requiring antihypertensive therapy and rate control in the context of AF.

Background: General Anaesthesia is a state of controlled unconsciousness. It makes it possible to have procedures that would be too painful or stressful to have while awake. Objective: to provide robust evidence to guide anesthetic choices in this challenging surgical population, ultimately improving patient care and outcomes in cancer surgery of head and neck. Methods: This Randomized controlled study was conducted in Department of Anaesthesiology, Rohilkhand Medical College and Hospital, Bareilly after obtaining Institutional Ethical Committee’s approval. Duration of Study was One year from August 2023 to July 2023. Result: Neither Desflurane nor Isoflurane consistently outperforms the other in terms of maintaining hemodynamic stability throughout the surgery. Patients receiving Desflurane however exhibited higher heart rates at certain period of time intraoperatively in comparison to isoflurane. Despite these differences, none are pronounced enough to clearly favor one agent significantly over the other across all time points. Conclusion: Desflurane outperformed Isoflurane in terms of recovery parameters. Patients who were administered Desflurane achieved faster spontaneous eye opening, swallowing, head raising, tongue protrusion, and regular breathing compared to those receiving Isoflurane.

Background: Inflammation plays a pivotal role in the pathogenesis and prognosis of ST-Elevation Myocardial Infarction (STEMI). Circulating biomarkers such as Interleukin-6 (IL-6), C-reactive protein (CRP), and Tumor Necrosis Factor-alpha (TNF-α) have been identified as potential indicators of myocardial injury and systemic inflammatory response. This study aimed to evaluate the correlation of these inflammatory markers with infarct severity and short-term outcomes in STEMI patients. Materials and Methods: A prospective cohort study was conducted involving 120 STEMI patients admitted to the coronary care unit of a tertiary hospital over 18 months. Serum levels of IL-6, CRP, and TNF-α were measured within 12 hours of symptom onset. The severity of myocardial infarction was assessed using peak troponin I levels and echocardiographic left ventricular ejection fraction (LVEF). Clinical outcomes including in-hospital complications and 30-day mortality were documented. Correlation analyses and multivariate logistic regression were applied. Results: Mean serum levels were: IL-6 (48.6 ± 12.3 pg/mL), CRP (28.4 ± 9.1 mg/L), and TNF-α (22.7 ± 7.4 pg/mL). A significant inverse correlation was found between IL-6 and LVEF (r = -0.58, p < 0.001), and a positive correlation with peak troponin I (r = 0.61, p < 0.001). Elevated CRP and TNF-α were also associated with higher Killip class at presentation (p = 0.01 and p = 0.02, respectively). Patients with biomarker levels in the highest tertile had a significantly increased risk of adverse in-hospital events (OR: 3.8, 95% CI: 1.9–7.5) and 30-day mortality (OR: 4.5, 95% CI: 2.1–9.2). Conclusion: Higher levels of IL-6, CRP, and TNF-α are strongly associated with greater infarct severity and poorer short-term outcomes in STEMI patients. These biomarkers may serve as valuable tools for early risk stratification and prognostic assessment in acute coronary settings.

Background: Post-COVID syndrome (PCS) has emerged as a significant health concern characterized by persistent, multisystemic symptoms lasting beyond the acute phase of SARS-CoV-2 infection. Systemic inflammation has been hypothesized as a major contributor to prolonged organ dysfunction. This study aimed to assess the association between key inflammatory biomarkers and the extent of multisystem involvement in patients diagnosed with PCS. Materials and Methods: This prospective observational study was conducted over six months at a tertiary care center. A total of 120 patients who had recovered from laboratory-confirmed COVID-19 infection but continued to experience symptoms for more than four weeks were enrolled. Blood samples were collected to measure levels of C-reactive protein (CRP), interleukin-6 (IL-6), ferritin, D-dimer, and erythrocyte sedimentation rate (ESR). Multisystem involvement was assessed based on clinical evaluation, laboratory investigations, and radiological findings involving cardiovascular, respiratory, neurological, renal, and musculoskeletal systems. Statistical analysis included chi-square tests and Pearson correlation coefficients, with a p-value <0.05 considered statistically significant. Results: Among the 120 participants (mean age: 45.2 ± 12.6 years; 62 males, 58 females), 68% showed involvement of at least two organ systems. Elevated CRP (>10 mg/L) was found in 72% of patients with multisystem involvement (p<0.001), and raised IL-6 (>7 pg/mL) in 64%. Ferritin levels were elevated (>300 ng/mL) in 58% of affected individuals, while D-dimer (>500 ng/mL) was raised in 43% and ESR (>30 mm/hr) in 61%. A positive correlation was observed between CRP and the number of systems involved (r=0.68), as well as IL-6 and symptom severity score (r=0.54). Conclusion: Inflammatory biomarkers, particularly CRP and IL-6, show strong predictive value for multisystem involvement in post-COVID syndrome. Routine assessment of these markers may aid early identification and risk stratification of patients at higher risk for prolonged morbidity.

Background: High-Intensity Interval Training (HIIT) has gained popularity for its efficiency in improving cardiovascular and respiratory health. However, limited data exist on its direct impact on cardiac output and pulmonary function in healthy young adults. This study aims to evaluate the physiological differences in these parameters between individuals regularly practicing HIIT and those leading sedentary lifestyles. Materials and Methods: A cross-sectional study was conducted among 60 young adults aged 18–25 years, divided into two groups: Group A (n=30) consisted of individuals engaging in structured HIIT sessions (≥3 sessions/week for ≥6 months), and Group B (n=30) included sedentary individuals with no regular exercise routine. Cardiac output was measured using Doppler echocardiography, while pulmonary function tests (PFTs) including Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), and Peak Expiratory Flow Rate (PEFR) were assessed using spirometry. Statistical analysis was performed using unpaired t-tests with a significance level set at p<0.05. Results: Group A demonstrated significantly higher mean cardiac output (6.3 ± 0.8 L/min) compared to Group B (4.9 ± 0.7 L/min, p<0.001). Similarly, pulmonary function parameters were elevated in the HIIT group: FVC (4.1 ± 0.3 L vs. 3.4 ± 0.4 L, p<0.001), FEV1 (3.7 ± 0.3 L vs. 3.1 ± 0.3 L, p<0.01), and PEFR (490 ± 30 L/min vs. 420 ± 35 L/min, p<0.01). No significant differences were noted in resting heart rate or blood pressure between groups. Conclusion: Regular participation in HIIT is associated with improved cardiac output and pulmonary function among young adults. These findings suggest that HIIT may serve as an effective non-pharmacological strategy to enhance cardiorespiratory fitness in this population.

Background: Sodium-glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are two modern antidiabetic drug classes that not only improve glycemic control but also exert beneficial cardiovascular effects. However, comparative data on their efficacy remains limited and warrants further evaluation to inform optimal therapeutic strategies for individuals with type 2 diabetes mellitus (T2DM). Materials and Methods: A prospective, open-label study was conducted among 120 patients with T2DM aged between 40–65 years. Participants were randomly assigned into two groups: Group A (n=60) received empagliflozin 10 mg/day (SGLT2i) and Group B (n=60) received liraglutide 1.2 mg/day (GLP-1 RA) for a period of 24 weeks. Primary endpoints included change in HbA1c, fasting blood glucose (FBG), and body weight. Secondary endpoints involved evaluation of systolic blood pressure (SBP), LDL-C, and occurrence of major adverse cardiovascular events (MACE). Data were analyzed using paired t-tests and ANOVA, with a significance level set at p<0.05. Results: At 24 weeks, Group A showed a reduction in HbA1c from 8.2% ± 0.6 to 7.1% ± 0.4, while Group B exhibited a greater reduction from 8.3% ± 0.5 to 6.8% ± 0.3 (p=0.04). FBG declined by 31.5 ± 8.2 mg/dL in Group A and 38.9 ± 7.5 mg/dL in Group B (p=0.03). Weight reduction was significantly higher in Group B (−4.8 ± 1.2 kg) than in Group A (−2.9 ± 1.0 kg). Improvements in SBP and LDL-C were more notable in the SGLT2i group. MACE incidence was comparable between groups, with 2 events in Group A and 1 in Group B. Conclusion: Both SGLT2 inhibitors and GLP-1 receptor agonists demonstrated significant glycemic and cardiovascular improvements in patients with T2DM. GLP-1 RAs offered superior glycemic control and weight loss, whereas SGLT2is provided better blood pressure and lipid profile modulation. Individualized therapy considering comorbid conditions may optimize patient outcomes.