Journal of Population Therapeutics and Clinical Pharmacology
The JPTCP is an international peer-reviewed journal publishing Editorials, Reviews, Full-text articles, Brief Communications and Case Reports in the field of medical and pharmacological practice.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
A STUDY ON KNOWLEDGE, ATTITUDE AND PRACTICES OF BIOMEDICAL WASTE MANAGEMENT IN DIAGNOSTIC HEALTHCARE CENTRES IN WEST BENGAL.
Biomedical waste (BMW) generated during diagnosis and treatment poses severe threats to the environment and healthcare personnel, including the transmission of diseases like HIV and Hepatitis. While India has established laws for BMW management, implementation and awareness remain unsatisfactory, particularly in the rapidly growing sector of smaller diagnostic facilities. Objectives: This study aimed to assess the Knowledge, Attitude, and Practices (KAP) regarding biomedical waste management, legislation, and safety among healthcare personnel in private diagnostic centres. Methods: A cross-sectional study was conducted over two months at three leading private diagnostic centres in West Midnapore, West Bengal. The study population consisted of 270 voluntary participants, comprising 45 doctors, 156 laboratory technicians, 30 laboratory attendants, and 39 general duty attendants. A pre-tested, structured questionnaire containing 30 questions (divided equally into knowledge, attitude, and practice domains) was used for data collection. Results: Knowledge regarding BMW legislation was found to be "good" in only 53.33% of doctors and 50% of technicians, while attendants and general duty staff scored significantly lower. Regarding attitude, 50% of the total participants considered BMW management an "extra burden" on their work. While doctors (30/45) and technicians (90/156) demonstrated "good" practice awareness, lower-tier staff fared poorly. Notably, 70% of all participants had poor awareness regarding post-exposure prophylaxis. Conclusion: The study reveals a critical gap in knowledge and awareness among healthcare personnel, including doctors and technical staff. Strict implementation of regulations, regular intensive training programs, and the involvement of top management are recommended to improve waste management practices and ensure occupational safety.
Biomedical Waste Management, KAP Study, Diagnostic Centres, West Bengal, Healthcare Personnel.
Copyright (c) 2025 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
ENHANCING ANATOMY REVISION THROUGH IMAGE-BASED, PART-COMPLETION GOOGLE FORMS: A CROSS-SECTIONAL STUDY AMONG FIRST-YEAR MBBS STUDENTS
Background: Digital formative assessments are increasingly used in medical education, but evidence on their impact when integrated with students’ own dissection images remains limited. This study evaluated the usefulness, engagement, and learner satisfaction associated with an image-based, part- completion Google Form designed to support revision of upper limb anatomy. Methods: A Google Form containing informed consent, demographic fields, ten short-answer questions based on images from students’ own dissections, a five-item engagement/satisfaction Likert scale, and an open-ended feedback prompt was administered to all first-year MBBS students (n=204). Students completed the form on their mobile phones during a scheduled revision session. Quantitative data (accuracy, completion time, perception scores) and qualitative feedback were analyzed descriptively. Results: 204 students completed the form (response rate 81.6%). Performance on image-based questions was high: 60% scored 90%, 25% scored 80-90%, 15% scored 70-80%, while only 10% scored below 70%. Mean completion time was 26 minutes. Perception scores indicated strong acceptance (mean 21.6 ± 2.3 out of 25). Students agreed that using images from their own dissections enhanced recall (93%) and improved conceptual understanding (90%). Thematic analysis of comments revealed three dominant themes: ownership & authenticity of learning, focused independent engagement, and reduced anxiety with increased motivation. Conclusion: The image-based, part-completion Google Form was well received, fostered strong engagement, and served as an effective tool for non-threatening revision. Embedding students’ own dissection images appears to enhance authenticity and ownership of learning. The model can be replicated for other anatomical regions in early medical education.
anatomy education, Google Forms, formative assessment, undergraduate medical students, dissection-based learning, engagement.
A STUDY ON THE EVALUATION OF CARDIAC DYSFUNCTION AMONG OLDER PEOPLE ATTENDING HOSPITAL FOR APPARENTLY NON-CARDIAC PROBLEM
An unprecedented increase in human longevity was one of the most spectacular events of 20th century. The United Nations held its second General Assembly on aging in Madrid, in April 02 and International Plan of Action on aging 2002 was adopted. The health component of this declaration was based on the document “Active aging: A policy frame work” prepared by WHO.2 In the year 2002 there were an estimated 605 million old person in the world of which 400 million were living in low income countries. Between 2000 and 2030, the number of older adults worldwide is expected to increase from 420 to 974 million. Cardiovascular disease is the most frequent diagnosis in elderly people and is the leading cause of death in both men and women 1 older than 65 years of age. The profile of these common cardiovascular diseases differs in older patients from that in younger patients. Systolic, but not diastolic, blood pressure increases with aging, resulting in increased pulse pressure. Systolic hypertension becomes a stronger predictor of cardiovascular events, especially in women. Heart failure with preserved systolic function becomes more common at older ages and is more common in women. Coronary artery disease (CAD) is more likely to involve multiple vessels and left main artery disease and is equally likely in women as in men older than 65 years of age. Equal numbers of older men and women present with acute myocardial infarction (MI) until age 80, after which more women present
COMPARATIVE ANALYSIS OF GENDER DIFFERENCES IN BIOCHEMISTRY PERFORMANCE AND ATTENDANCE
The study was aimed to investigate the first year BDS (Bachelor of Dental Surgery) students’ performance in Biochemistry. It examined the impact of gender and class attendance on the students' theory and practical scores. The research was designed on the cross-sectional survey. The sample comprised 142 BDS students of private medical colleges. The data was analysed using Analysis of Variance, and linear regression. The results indicated a significant difference based on gender and attendance, which indicate that both variables have a great impact on academic outcomes. It was also observed that female students have greater average scores as compared to male students. Regression analysis revealed a strong positive prediction effect of attendance and academic performance. However, no significant interaction effects between attendance and gender were observed. Therefore, it was concluded that regular class attendance is advantageous for both male and female students. Maintaining class attendance is elementary to academic successes, and this idea is reflected in the learning outputs among dental students.
Copyright (c) 2024 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
EFFECTIVENESS OF A STRUCTURED SENSITIZATION PROGRAMME ON PREPAREDNESS AND ATTITUDES OF FIRST-YEAR MBBS STUDENTS TOWARDS THE FAMILY ADOPTION PROGRAMME: A PROSPECTIVE STUDY
Contemporary medical education increasingly emphasizes community-oriented, competency-based training to prepare socially accountable physicians. The Family Adoption Programme (FAP), introduced by the National Medical Commission, aims to provide early community exposure to undergraduate medical students. However, first-year MBBS students often experience anxiety, lack of preparedness, and limited understanding of community dynamics, underscoring the need for structured sensitization prior to field engagement. Objectives: To assess the effectiveness of a structured sensitization programme in improving preparedness, knowledge, and attitudes of first-year MBBS students towards participation in the Family Adoption Programme. Methods: A prospective interventional study was conducted over six months in the Department of Community Medicine, NIMDS&R. All first-year MBBS students of the 2024–2025 academic session was included through complete enumeration. Participants underwent a structured sensitization programme followed by pre- and post-intervention assessments using validated, semi-structured questionnaires. Outcomes measured included changes in knowledge scores, attitudes towards community engagement, and readiness for FAP. Student satisfaction and qualitative feedback were collected through reflection and debriefing sessions. Quantitative data were analyzed using appropriate statistical tests, while qualitative responses were subjected to thematic analysis using a manual coding framework. Results: The sensitization programme demonstrated improvement in students’ knowledge regarding social determinants of health, enhanced positive attitudes towards community engagement, and increased readiness for participation in FAP. Students reported high satisfaction with the training methods and expressed greater confidence in interacting with families in community settings. Conclusion: Structured sensitization prior to community exposure significantly enhances the preparedness, knowledge, and attitudes of first-year medical students, supporting the effectiveness of FAP as a valuable educational tool in undergraduate medical training.
Family Adoption Programme (FAP); Sensitization; Community-based learning; Early clinical exposure; Social accountability; Medical education; MBBS students
Less than 1% of all breast tumors are phyllodes tumors, which are uncommon fibroepithelial neoplasms. Women in their middle years are typically affected, and they often present with a palpably expanding mass. Only 1.5% of malignant phyllodes tumors spread, despite their tendency to grow quickly. The significance of sufficient surgical margins is further supported by the fact that they are linked to a greater likelihood of recurrence than their benign equivalents. Therefore, early detection of malignant tumors is essential for timely removal and careful monitoring. Here, we describe the case of a 35-year-old woman who had a quickly expanding right breast mass that was pathologically determined to be a phyllodes tumor, despite having no known personal or family history of breast cancer. She underwent lump excision, and the biopsy revealed that it was malignant phylloides. Following that, the patient had a full body PET-CT scan, which revealed soft tissue borders in the right breast that were slightly metabolically active, implicating NAC and the underlying chest muscles. Simple mastectomy was done one and a half months later, and the skin and base were free of tumors, and the portion had negative margins.
Malignant phyllodes tumor, breast lump, cystic solid lesion, mastectomy, Histopathological finding
EARLY VERSUS DELAYED MOBILIZATION AFTER VALVE SURGERY: IMPACT ON RECOVERY AND LENGTH OF HOSPITAL STAY: A RETROSPECTIVE STUDY
Enhanced postsurgical recovery in cardiac surgery aims to reduce complications, promote early physical function, and shorten hospitalization. Early mobilization has emerged as a key component of cardiac rehabilitation and enhanced recovery pathways, contributing to improved functional outcomes and reduced morbidity after major cardiothoracic procedures.¹⁻³ Early mobilization helps counteract postoperative deconditioning, reduces pulmonary complications, improves muscle strength, and accelerates return to baseline activity.⁴⁻⁶ Despite these known benefits, the adoption of structured mobilization protocols in resource-limited settings remains inconsistent due to staffing constraints, lack of standardized guidelines, and varying postoperative hemodynamic stability in patients.⁷ Several international studies have demonstrated the benefits of early mobilization following cardiac surgery. Phillips et al. (2013) reported improved functional capacity and reduced pulmonary complications in patients mobilized within 48 hours of surgery.⁸ A systematic review by Fagan et al. (2022) concluded that early mobilization significantly enhances physical recovery and shortens hospital stay.⁹ Similarly, Tadyanemhandu et al. (2020) found that early physiotherapy interventions were associated with shorter ICU duration and reduced postoperative complications.¹⁰ A meta-analysis by Ferreira et al. (2020) also supported early mobilization, demonstrating improvements in functional outcomes and reduced length of stay.¹¹ Specific evidence for valve surgery populations is emerging. Funamoto et al. (2021) reported improved early ambulation and shorter hospitalization after structured mobilization in valve surgery patients.¹² In another study, Vahlberg et al. (2023) emphasized that early physical therapy improved strength and reduced postoperative pulmonary events in valve replacement patients.¹³ However, despite increasing global evidence, data on early mobilization in Indian cardiac surgery—particularly valve surgery—remain limited. Variability in rehabilitation practices, patient demographics, and institutional resources creates a gap in understanding real-world outcomes. Therefore, the present study aims to compare early versus delayed mobilization after valve surgery in a tertiary care centre, focusing on recovery time, hospital stay, and postoperative complications. This study may provide valuable region-specific evidence to support structured early rehabilitation practices in cardiac surgery programs.
EFFECTIVENESS AND SAFETY OF ANTIPLATELET THERAPY FOLLOWING VALVE SURGERY: A RETROSPECTIVE STUDY
Antiplatelet therapy is commonly prescribed after surgical valve replacement to prevent thromboembolic events; however, data from real-world tertiary-care settings in India on its effectiveness and safety remain limited. Aim: To evaluate the effectiveness and safety outcomes associated with antiplatelet therapy following valve surgery in adult patients at a tertiary care centre. Methods: This retrospective study analysed medical records of 312 adult patients who underwent mechanical or bioprosthetic valve surgery between January 2022 and December 2024. Patients receiving postoperative antiplatelet therapy (aspirin or clopidogrel), with or without oral anticoagulation, were included. Primary effectiveness outcomes were valve thrombosis, ischemic stroke, and systemic embolism at 12 months. Safety outcomes included major and minor bleeding events. Data were examined descriptively and through adjusted hazard ratios. Results: A total of 312 patients were evaluated, of whom 198 (63.5%) had mechanical valves and 114 (36.5%) had bioprosthetic valves. Aspirin monotherapy was used in 84 patients (26.9%), dual therapy with aspirin plus VKA in 186 (59.6%), and clopidogrel-based therapy in 42 (13.5%). Over 12 months, thromboembolic events occurred in 12 patients (3.8%), including valve thrombosis (1.6%), ischemic stroke (1.3%), and systemic embolism (0.9%). Major bleeding occurred in 13 patients (4.1%) and minor bleeding in 30 patients (9.6%). Dual therapy did not demonstrate a significant reduction in thromboembolic events compared with aspirin alone (adjusted HR 0.82; 95% CI 0.34–1.96; p = 0.64), but showed a higher, non-significant trend toward major bleeding (adjusted HR 1.48; 95% CI 0.68–3.19; p = 0.31). Conclusion: In this retrospective cohort of valve-surgery patients, antiplatelet therapy—particularly in combination with anticoagulation—was commonly used. While thromboembolic events were infrequent, bleeding complications were more frequent among those receiving dual therapy. These findings support an individualized approach when selecting postoperative antithrombotic regimens and highlight the need for larger prospective studies in Indian populations.
Antiplatelet therapy, valve surgery, aspirin, safety, thromboembolism, retrospective study, tertiary care.
PRENATAL SCREENING AND DIAGNOSIS OF THALASSEMIA: PREVENTING THALASSEMIC BIRTHS
Thalassemia is one of the most common hereditary disorders in India. Early antenatal screening, spousal testing, and prenatal diagnosis (PND) are key strategies to prevent thalassemia major births. Objectives: To assess the role of antenatal screening, spousal testing, and PND in identifying carrier couples and reducing thalassemia major births. Methods: A cross-sectional study was conducted at RNT Medical College, Udaipur, including 1,280 pregnant women in the first and early second trimester. Screening was done using high- performance liquid chromatography (HPLC). Carrier women were advised spousal testing; at- risk couples were offered PND through chorionic villi sampling (CVS) or amniocentesis. Results: The total 1,280 pregnant women were screened, of wich 92 (7.2%) were identified as carriers. The most common abnormality was beta-thalassemia trait (5.0%), followed by sickle cell trait (1.25%) and rare variants such as Hb-D, Hb-E, Hb-C, and alfa-thalassemia. Among 68 spouses tested, 5 (7.4%) had beta-thalassemia trait and 1 (1.5%) had sickle cell trait. Five couples were classified as “at risk”; four underwent prenatal diagnosis, which detected one fetus with thalassemia major, two with thalassemia minor, and one normal fetus. The acceptance rate of prenatal testing was 80%. Conclusion: Antenatal screening with spousal testing and PND is feasible and effective in preventing thalassemia major births. Integration of such programs into routine maternal care, especially in high-prevalence tribal areas, is essential.
Thalassemia, Antenatal Screening, Prenatal Diagnosis, Hemoglobinopathies, β- thalassemia Trait, Pregnancy
A PROSPECTIVE CASE CONTROL STUDY COMPARING SHORT-TERM AND LONG-TERM OUTCOMES OF SUBFASCIAL ENDOSCOPIC PERFORATOR SURGERY AND OPEN SUBFASCIAL PERFORATOR LIGATION IN THE MANAGEMENT OF VARICOSE VEINS
Varicose veins are dilated, elongated, and tortuous superficial veins of the lower limbs, primarily caused by venous valve incompetence and resulting in venous hypertension. Persistent reflux leads to progressive chronic venous insufficiency (CVI), stasis eczema and chronic non-healing ulcers. [1][2] Homans in 1916, first described the key role of perforator veins (PVs), in the pathophysiology and severity of CVI and venous ulceration. [3][4][5] Diagnosis is by clinical evaluation, Duplex Doppler imaging. [1] Clinical Aetiologic Anatomic Pathophysiologic (CEAP) classification, established in 1994, is a precise diagnostic tool to assess and categorise a chronic venous disease. [6][7] Ligation of incompetent perforator veins remains a central component in the management of varicose veins, given their significant contribution to the pathophysiology of chronic venous insufficiency. Management approach includes conservative therapy with compression garments, minimally invasive techniques such as sclerotherapy, endovenous laser ablation, radiofrequency ablation, Subfascial Endoscopic Perforator Surgery (SEPS) and traditional open subfascial perforator ligation (OSPL). [2] SEPS provides access to incompetent perforators through limited incisions, enabling precise identification and their ligation, even the ones missed on clinical examination or duplex doppler. [8][9]
UNUSUAL CAUSE OF LIFE-THREATENING RESPIRATORY DISTRESS FOLLOWING HYBRID TEVAR FOR DUCTAL AORTIC ARCH ANEURYSM- A RARE CASE REPORT
Hybrid TEVAR (Thoracic Endovascular Aortic Repair) is a recent technical advancement combining an interventional procedure along with an open surgical technique for avoiding risks of open surgical procedure and at the same time having the advantage of minimal intervention and enhanced recovery with optimisation of neck vessel revascularisation. We report a case of an elderly gentleman who presented with dyspnoea and hemoptysis. He was evaluated and diagnosed with an aortic arch aneurysm. He underwent hybrid TEVAR with open surgical carotico-carotid bypass followed by endovascular stent grafting of the aortic aneurysm. Patient had a preexisting left vocal cord palsy, probably due to Ortner’s / Cardio vocal syndrome. Post procedure, he developed life-threatening respiratory distress requiring reintubation. Symptoms improved within 48 hours, and extubated and discharged in stable condition. We present this case to highlight the possible factors responsible for transient vocal cord palsy in carotid surgical interventions and also the rare occurrence of bilateral vocal cord palsy resulting in life-threatening respiratory distress in the case of hybrid aortic interventions with undiagnosed unilateral vocal cord palsy, which necessitates preoperative video laryngoscopy evaluation for any patient planned for hybrid aortic interventions.
Ductal aortic aneurysm, hybrid TEVAR, vocal cord palsy, recurrent laryngeal nerve injury
CLINICAL AND BIOCHEMICAL DETERMINANTS OF PEADIATRIC GALLSTONE DISEASE: A SINGLE-CENTER RETROSPECTIVE ANALYSIS
Biochemical, hematologic, and anatomical factors all have an impact on the symptoms of pediatric gallstone disease, which is becoming more widely recognized in a variety of clinical settings. Although its frequency appears to be rising, region-specific data from eastern India remain inadequate, notably on the contribution of hemoglobinopathies and the diversity in ultrasonographic and biochemical profiles. This study aimed to characterize the clinical, biochemical, hematologic, and ultrasonographic determinants of pediatric gallstone disease at a tertiary-care center in eastern India and to identify patterns that may support early recognition and management. A retrospective review of 52 children aged 2.67-14 years with ultrasonography-confirmed gallstones was conducted. Data extracted from hospital records included demographics, symptoms, comorbidities, biochemical indices, ultrasonographic features, surgical details, and hospitalization outcomes. Descriptive summaries of continuous data were made, and trend analysis was used to look at clinical-biochemical connections. Gallstones occurred across a broad age range, with peaks at 6-8 years and 10-12 years, and a predominance among males. Urban and semi-urban districts contributed to most cases. Abdominal pain was the most frequent symptom, although several diagnoses were incidental. Biochemical parameters were largely preserved, with occasional elevations in SGOT, SGPT, and WBC counts. Hemoglobinopathies, especially sickle cell disease and β-thalassemia trait, emerged as important associated factors. Ultrasonography demonstrated heterogeneous gallbladder and biliary findings. Hospital stays were short, and surgical management was uniform. Pediatric gallstone disease in this region appears to have multifactorial origins, influenced by age distribution, hemoglobinopathies, and diverse ultrasonographic patterns. Early identification of metabolic and hematologic contributors may enhance timely diagnosis and guide future risk-stratification strategies.
pediatric gallstones, hemoglobinopathy, gallstone diseases, biochemical profile, retrospective study
ISOLATION AND MOLECULAR IDENTIFICATION OF L-ASPARAGINASE PRODUCING FUNGI FROM SOIL
L-asparaginase (L-asparagine amido hydrolase, E.C.3.5.1.1) is an extra cellular enzyme that has received considerable attention since it is used as an anticancer agent as well as for industrial application especially to reduce the acrylamide formation in fried foods. In the present study, the fungal isolates from rhizosphere soils were screened for the L-asparaginase production by using modified Czapek Dox agar containing L-asparagine and phenol red as indicator. The strain isolated from rhizosphere soil of Ipomoea muricata showed the maximum zone diameter of 1.05 cm. The 16s rDNA sequence analysis indicated that the strain was most closely related to Fusarium equiseti (99% similarity) and the 766 nucleotide sequences has been deposited to the GenBank (National Centre for Biotechnological Information, USA, with accession number JN400528).
Copyright (c) 2021 Journal of Population Therapeutics and Clinical Pharmacology http://creativecommons.org/licenses/by-nc/4.0
COMPARATIVE STUDY OF INCIDENCE, RISK FACTORS AND OUTCOMES OF ACUTE KIDNEY INJURY IN POSTOPERATIVE PERIOD AFTER ON PUMP CABG VS ON PUMP CABG + VALVE REPLACEMENT SURGERY WITHOUT PREOPERATIVE MEDICAL RENAL DISEASE IN A TERTIARY CARE CENTRE
To compare the incidence, risk factors, and outcomes of acute kidney injury (AKI) in the postoperative period among patients undergoing on-pump coronary artery bypass grafting (CABG) alone versus those undergoing on-pump CABG with valve replacement surgery, in the absence of pre-existing medical renal disease. Methods: This retrospective observational study included 100 patients—50 each undergoing on-pump CABG alone and on-pump CABG with valve replacement. Patients with prior renal dysfunction were excluded. Data were collected on demographic, preoperative, intraoperative, and postoperative variables. AKI was diagnosed based on KDIGO criteria. Statistical analysis was performed using Jamovi software. Group comparisons were made using appropriate statistical tests, and the predictive value of AKI for mortality was assessed using ROC curve analysis. Results: The incidence of AKI was higher in the CABG + valve group (60%) than in the CABG-only group (50%), with more severe staging and greater dialysis requirement (34% vs 22%). The CABG + valve group had significantly higher preoperative creatinine levels and longer cross-clamp and CPB times. Intraoperative CPB flow rates and hematocrit were significantly lower, while fluid balance was more positive in CABG + valve group. Postoperatively, the CABG + valve group had greater use of inotropes, diuretics, and transfusions, along with higher serum creatinine levels, prolonged ventilation, ICU stay, and hospital stay. In-hospital mortality was also higher (30% vs 20%). ROC analysis confirmed AKI as a strong predictor of mortality (AUC 0.936 in CABG; 0.855 in CABG + valve group). Conclusion: CABG with valve replacement is associated with a higher risk and severity of AKI and worse postoperative outcomes. Early identification and optimized perioperative care are critical to mitigate AKI-related complications.
Acute Kidney Injury, Cardiopulmonary Bypass, Coronary Artery Bypass Grafting, Valve Replacement Surgery, Postoperative Complications.
RISK FACTORS AND OUTCOMES OF LOW-BIRTH-WEIGHT DELIVERIES IN TERTIARY CARE SETTINGS: A CROSS-SECTIONAL STUDY FROM GUJARAT
: Low-birth-weight (LBW) remains a significant public health challenge in India, contributing substantially to neonatal morbidity and mortality. Gujarat, despite economic progress, continues to witness considerable variations in maternal and child health indicators across its districts. Objectives: To identify the prevalence and risk factors associated with low-birth-weight deliveries and to evaluate immediate neonatal outcomes among LBW infants at a tertiary care hospital in Gujarat. Methodology: A hospital-based cross-sectional study was conducted at Swaminarayan Institute of Medical Sciences & Research, Kalol, Gandhinagar, from November 2024 to February 2025. A total of 384 mother-infant pairs were enrolled using systematic random sampling. Data were collected through structured interviews and medical record reviews. Statistical analysis was performed using SPSS version 26.0, employing chi-square tests, logistic regression, and descriptive statistics. Results: The prevalence of LBW was found to be 28.4%. Significant risk factors included maternal anemia (adjusted OR: 3.82, 95% CI: 2.14-6.81), inadequate antenatal care visits (adjusted OR: 2.96, 95% CI: 1.68-5.22), low maternal body mass index (adjusted OR: 2.47, 95% CI: 1.42-4.29), and gestational hypertension (adjusted OR: 2.18, 95% CI: 1.24-3.83). LBW infants demonstrated significantly higher rates of neonatal complications including respiratory distress (42.2% vs 8.6%, p<0.001), hypoglycemia (31.8% vs 5.2%, p<0.001), and requirement for special newborn care unit admission (58.7% vs 12.3%, p<0.001). Conclusion: The study highlights a concerning prevalence of LBW deliveries in this tertiary setting, predominantly influenced by preventable maternal factors. Strengthening antenatal care services, addressing maternal nutritional deficiencies, and ensuring adequate pregnancy surveillance are critical interventions needed in the region.
Low-birth-weight, risk factors, neonatal outcomes, tertiary care, Gujarat
“A CLINICAL STUDY OF BILVADIPANCHMULA KWATH WITH MADHU IN THE MANAGEMENT OF STHAULYA (OBESITY)”
In Presnt era every person is running after life,s goal. Hence does not have time to think and act for the healthy life and also not able to follow the proper Dincharya, Ratricharya, Ritucharya and rules for healthy living as per Ayurveda and other life sciences so that obesity has taken place as an major problem in majority of peoples. Sthaulya (Obesity) is such a disease ,which provides the platfrom for so many disease and complication like hypertension, Congenital heart disease, diabetes mellitus, impotency as well as psychological disorders like stress, anxiety, depression etc. so in present study “A Clinical study of Bilvadipanchmula kwath with Madhu in the management of Sthaulya (Obesity)”. We try to prove our hypothesis with data collected and analysed on the basis of patient taken in OPD and IPD level as open level randomized clinical trial. The material method , Analysis of data, Result and Conclusion is elaborated in the following Article.
Ayurveda , Dincharya, Sthaulya , Bilvadipanchamula Kwath, Data Analysis.
RADIOLOGICAL ANALYSIS OF SKELETAL MANIFESTATIONS IN THE LONG BONES AND SPINE IN RELATION TO THYROID HORMONAL DISORDERS.
Thyroid hormones play a crucial role in maintaining bone mineral homeostasis and skeletal integrity. Both hyperthyroidism and hypothyroidism can alter bone remodeling, potentially leading to osteopenia, osteoporosis, and increased fracture risk. This study aimed to analyze the radiological skeletal manifestations in the long bones and spine of patients with thyroid hormonal disorders and to correlate these findings with thyroid function status. Materials and Methods: A cross-sectional observational study was conducted in the Department of Radiology, in collaboration with the Department of Anatomy at Sarojini Naidu Medical College Agra, and Mahamaya Rajkiya Allopathic Medical College, Ambedkar Nagar from October 2024 to March 2025. A total of 129 subjects were included—60 hypothyroid (Group I), 44 hyperthyroid (Group II), and 25 euthyroid controls (Group III). Standard radiological imaging of long bones and spine was performed, and findings were compared among groups. Statistical analysis was done to determine the significance of differences. Results: Radiological abnormalities were significantly more frequent in thyroid disorder groups compared to controls. Generalized osteopenia was observed in 58% of hypothyroid and 66% of hyperthyroid patients (p < 0.001). Cortical thinning and coarse trabecular patterns were also prevalent (p < 0.001 and p = 0.002, respectively). In the spine, decreased vertebral bone density was seen in 53.3% of hypothyroid and 68.2% of hyperthyroid patients (p < 0.001). Biconcave vertebrae and compression deformities were also more common among thyroid disorder groups. Females were predominantly affected across all groups. Conclusion: Thyroid hormonal disorders are associated with significant skeletal changes detectable through radiological imaging, primarily osteopenia, cortical thinning, and reduced vertebral bone density. Early imaging assessment in patients with thyroid dysfunction is recommended to detect bone loss and prevent fracture-related complications.
Thyroid disorders, Bone mineral density, Osteopenia, Radiological analysis, Spine, Long bones, Hypothyroidism, Hyperthyroidism.
DETECTION OF IMPORTANCE OF RIFAMPICIN AND ISONIAZID RESISTANCE AND DETERMINE RATE OF MDR-TB IN POSITIVE SMEAR SPUTUM SAMPLES FROM A TERTIARY CARE HOSPITAL OF M.P
One of the most effective strategies used to control tuberculosis is anti-tubercular therapy. In india various studies are reported earlier, the prevalence rate of MDR-TB very from region to region. Therefore , we determine rate of multi drug resistant –TB, Isoniazid and Rifampicin Mono resistance and common mutation pattern associated with them from our area using Genotype MTBDR plus assay in order to provide better patient care and reduce rate of Multi Drug Resistance –TB. This was a cross sectional study comprising of 800 sputum samples collected from DOTS center and processed by ZN staining and LPA. out of 800 sputum sample, 168 were smear positive . rate of MDR was found 9.88%. commonest mutation pattern seen was S531L in rifampicin and S315T1 in isoniazid. We found there is a high rate of INH mono resistance which was not being detected till now from this area and we also found, there is unrelated risk of isoniazid and rifampicin mono resistance so, inference of MDR based on RIF mono-resistance is also an inaccurate strategy to manage patients and drug sensitivity should be performed for both first line drug before stating MDR.
THE IMPACT OF UTERINE ARTERY DOPPLER ASSESSMENT AT 11-13+6 WEEKS GESTATIONAL AGE ON STRATIFICATION OF EARLY ONSET PREECLAMPSIA AT A TERTIARY CARE TEACHING HOSPITAL IN NORTH INDIA
: Clinical history alone that is used to stratify risk to develop preterm preeclampsia in pregnant women may overestimate the number of pregnant women that need preventative therapy with low dose aspirin. Integration of mean arterial blood pressure (MAP) and mean uterine artery pulsatility index (mean UtA PI) Doppler studies with clinical history can reduce the proportion of women identified at high risk and consequently started on low dose aspirin. Aim: The purpose of this study was to quantify the difference in the proportion of women identified at high risk for preterm PE using a combined screening model and clinical history alone model. Materials and methods: A cross sectional study of pregnant women screened between 11-13+6 gestational weeks included clinical history, mean arterial blood pressure measurements (MAP) and mean uterine artery pulsatility index (Mean UtA PI) using fetal Doppler assessment for all enrolled women. An individualized risk for preterm preeclampsia based on clinical history alone and risk based on clinical history combined with MAP and Mean UtA PI was determined using a cutoff of 1 in 150 and the Fetal Medicine Foundation online calculator. The difference in the proportion of high-risk women using these two strategies was determined and a pairwise correlation test to correlate the two risk scores. Results: The study included 49 pregnant women screened between 11-13+6 gestational weeks from March to September 2025. Screening by clinical history alone identified 36 (73.47%) first trimester women at high risk compared to 19 (38.78%) pregnant women identified at high risk using the combined screening model (p=0.0006).The pairwise correlation (0.28) of risk scores by history alone and the combined screening model was poor. Conclusions: The integration of MAP and Mean UtA PI with clinical history will significantly reduce the number of women identified at high risk for preterm PE and consequently reduce the number of women that must be provided low dose aspirin and need more frequent surveillance. This will reduce the strain on health care infrastructure and economic strain on patients
Preeclampsia, uterine artery Pulsatility index, Mean arterial pressure
COMPARATIVE EVALUATION OF PERIPHERAL BLOOD SMEAR, RBC INDICES, AND RBC HISTOGRAM IN THE DIAGNOSIS OF ANAEMIA IN ADULTS AT A TERTIARY CARE CENTRE
Anaemia is a major global health concern with high prevalence in low- and middle- income countries. Accurate classification of anaemia is essential for appropriate management. Peripheral blood smear (PBS) examination provides detailed morphological information, while automated haematology analyzers offer objective RBC indices and histogram patterns. Limited studies have compared these modalities in adult anaemic populations in India. Aim: To evaluate peripheral blood smear findings in adult anaemia and compare them with RBC indices and RBC histogram patterns for identifying concordance and diagnostic utility. Materials and Methods: This descriptive cross-sectional study included 390 adults with haemoglobin <11 g/dL at a tertiary care centre in Udaipur. Venous blood samples were analyzed using a HORIBA six-part differential haematology analyzer. RBC indices (MCV, MCH, MCHC, RDW) and histogram patterns were recorded. Peripheral blood smears were prepared, Giemsa- stained, and examined for morphological classification. Anaemia was categorized as normocytic normochromic, microcytic hypochromic, macrocytic, dimorphic, or haemolytic. Correlation between PBS morphology, RBC indices, and histogram interpretation was evaluated using Chi- square and t-tests. A p-value <0.05 was considered significant. Results: Females constituted 62.31% of cases. The mean age was 36.87 ± 16.74 years, with most cases occurring in the 18–28 years age group. The most common clinical symptoms were fatigue (69.23%) and shortness of breath (65.38%). Histogram interpretation showed 54.10% normocytic normochromic, 37.69% microcytic hypochromic, 6.15% macrocytic, and 2.05% dimorphic patterns, identical to PBS morphology (p = 1). Histogram curve patterns showed a significant association with PBS findings (p < 0.001), with normal curves correlating with normocytic anaemia, left- shifted curves with microcytic anaemia, and bimodal curves with dimorphic anaemia. RBC indices also demonstrated expected changes across anaemia types. Conclusion: PBS examination, RBC indices, and histogram interpretation are complementary diagnostic tools in anaemia evaluation. The strong concordance between histogram patterns and PBS morphology underscores the reliability of automated analysis. Combining both manual and automated methods enhances diagnostic accuracy and should be routinely incorporated into haematological assessment.
Anaemia, Peripheral Blood Smear, RBC Histogram, RBC Indices, Normocytic Anaemia, Microcytic Anaemia, Automated Haematology Analyzer
ASSESSMENT OF FACTORS PREDICTING MORTALITY IN TRAUMA PATIENTS USING REVISED TRAUMA SCORE: A PROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA
Trauma constitutes a major public health burden globally, with developing countries bearing a disproportionate share of mortality and morbidity. Early identification of high-risk patients through validated scoring systems is essential for optimal triage and resource allocation. The Revised Trauma Score (RTS), incorporating Glasgow Coma Scale, systolic blood pressure, and respiratory rate, serves as a widely utilized physiological scoring tool for mortality prediction. This study aimed to assess factors predicting mortality in trauma patients using RTS and evaluate its predictive accuracy in an Indian tertiary care setting. Methods: A prospective observational study was conducted at Gouri Devi Institute of Medical Sciences and Hospital, West Bengal, from July 2024 to December 2024. A total of 168 trauma patients meeting inclusion criteria were enrolled through consecutive sampling. Demographic data, injury characteristics, and RTS parameters were recorded. Mortality prediction accuracy was assessed using receiver operating characteristic curve analysis, and logistic regression identified independent predictors. Results: The study population comprised predominantly males (82.1%) with mean age of 37.42 years. Road traffic accidents were the leading mechanism (66.7%). Overall mortality was 16.7%. Non-survivors had significantly lower mean RTS (3.68 vs. 6.82, p<0.001) compared to survivors. The RTS demonstrated excellent discriminatory ability with area under curve of 0.924. At optimal cutoff of 5.68, sensitivity was 89.3% and specificity was 87.1%. Glasgow Coma Scale below 9 emerged as the strongest mortality predictor (OR: 8.64). Conclusion: The Revised Trauma Score effectively predicts mortality in trauma patients, demonstrating excellent discriminatory ability. Implementation of RTS-based triage protocols is recommended for emergency departments in resource-limited settings to facilitate early identification of high-risk patients.
Revised Trauma Score, Trauma mortality, Glasgow Coma Scale, Injury severity, Emergency triage
EVALUATION OF DELAYS IN EMERGENCY CARE OF TRAUMA PATIENTS USING THE THREE-DELAY FRAMEWORK: A PROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE HOSPITAL
Trauma remains a leading cause of mortality and morbidity globally, with outcomes significantly influenced by timeliness of care. The golden hour concept emphasizes that definitive treatment within 60 minutes of injury optimizes survival. However, multiple barriers delay trauma care in resource-limited settings. This study aimed to evaluate delays in emergency trauma care using the three-delay framework and identify factors associated with each phase of delay. Methods: A prospective observational study was conducted at Gouri Devi Institute of Medical Sciences and Hospital, West Bengal, from March to August 2025. Two hundred adult trauma patients requiring emergency care were enrolled using consecutive sampling. Data on demographics, injury characteristics, and delays across three phases (decision to seek care, reaching healthcare facility, and receiving treatment) were collected using a structured proforma. Statistical analysis included chi-square tests, t-tests, and multivariate logistic regression. Results: Only 12% of patients received definitive care within the golden hour, with median total delay of 156 minutes. Phase 2 delays (median 68 minutes) contributed most substantially. Mortality was significantly higher among patients with delays exceeding 120 minutes (9.9% vs. 3.4%, p=0.048). Independent predictors of prolonged delay included rural residence (OR: 2.86), referral from other facilities (OR: 4.24), distance exceeding 20 km (OR: 3.12), unawareness of emergency helpline (OR: 2.14), and off-hours arrival (OR: 1.86). Conclusion: Substantial delays exist across all phases of trauma care, with transportation and referral-related factors contributing most significantly. Systematic interventions addressing geographic accessibility, emergency service awareness, and healthcare system capacity are urgently needed to improve trauma outcomes.
Trauma care delays; Three-delay model; Golden hour; Emergency medical services; Prehospital care
DEVELOPMENT, OPTIMIZATION, AND CHARACTERIZATION OF PLANT-POLYMER HARD CAPSULES PREPARED FROM CORN STARCH, AGAR-AGAR, SODIUM ALGINATE, AND HPMC
This study presents the development and optimization of a plant-polymer–based hard capsule using corn starch, agar-agar, sodium alginate, and hydroxypropyl methylcellulose (HPMC). A standardized sequence of gel preparation, pH adjustment, polymer blending, dipping-molding, and controlled drying was employed to obtain mechanically stable capsule shells. The prepared capsules were evaluated for hardness, moisture content, dimensional uniformity, disintegration time, surface characteristics, and pH stability. Results showed superior properties compared to previously reported plant-based capsules, with hardness ranging from 4.8–6.2 N, moisture level of 7.5–9.8%, and rapid disintegration within 11–16 minutes. FTIR and DSC confirmed polymer compatibility, while SEM revealed a uniform morphology without cracks. Overall, the study offers an eco-friendly, economical alternative to gelatin capsules while improving functional performance, demonstrating that a quadruple-polymer matrix can significantly enhance capsule mechanical strength and dissolution behavior.
Plant-based capsules; Hydrocolloid polymers; HPMC; Sodium alginate; Starch capsules; Agar-agar; Capsule formulation; Mechanical strength; Disintegration; Biopolymer blends.
A SYSTEMIC REVIEW:ERRORS IN INHALER USE INTRODUCTION
Inhalation therapy is the cornerstone of successful management of obstructive airway diseases (OADs) such as asthma and chronic obstructive pulmonary disease (COPD) due to its two-fold benefits – drug delivery to the target organ, and less systemic exposure with minimal adverse effects on other organs.Different types of inhaler devices such as pressurized metered-dose inhalers (pMDIs) with or without spacers, dry powder inhalers (DPIs), breath-actuated inhalers (BAIs) and nebulizers are available, which provide the physician and the patient the opportunity to select/use a device based on the ability of patients and preference of patient and physicians. Despite this, most physicians report poor inhaler technique and non-adherence to inhaler devices among their patients, which can result in a high economic burden on healthcare cost and utilization, both directly and indirectly, involving exacerbations, increased hospitalizations/hospital visits, poor quality of life and increased morbidity and mortality[31]
RELATIONSHIP BETWEEN SEVERE VITAMIN D DEFICIENCY AND FREQUENCY OF COPD EXACERBATIONS: A RETROSPECTIVE COHORT STUDY AT A TERTIARY CARE CENTER IN NORTH INDIA
Chronic Obstructive Pulmonary Disease (COPD) is a significant and escalating public health concern in India, contributing substantially to disability-adjusted life years (DALYs), particularly within large, environmentally challenged states such as Uttar Pradesh.1 Acute Exacerbations of COPD (AECOPDs) are critical events that accelerate lung function decline, drive morbidity, and account for a large proportion of healthcare expenditure.2 Vitamin D (25-hydroxyvitamin D) is recognized for its crucial, non-skeletal functions in regulating host immunity and systemic inflammation, which are key defense mechanisms against respiratory infections and exacerbation triggers.3 Hypovitaminosis D is endemic across the Indian subcontinent, affecting an estimated 70% to 100% of the general population.1 Recent international cohort data suggest a high risk of severe exacerbations is concentrated specifically within the subpopulation experiencing severe vitamin D deficiency (SVDD, defined as <10 ng/mL).4 Local quantification of this risk in North India is crucial for developing regionally relevant clinical protocols. Objectives: The primary aims of this study were: To determine the prevalence of categorized 25(OH)D statuses (Severe VDD, Deficiency, Insufficiency, and Sufficiency) within a local COPD cohort at the Career Institute of Medical Science & Hospital; To quantify the independent association between SVDD (<10 ng/mL) and the frequency of AECOPDs requiring hospitalization over a subsequent 06-month follow-up period. Methodology: This retrospective, single-center observational cohort study involved the review of electronic health records (EHR) for N=530 adult patients diagnosed with spirometrically confirmed COPD. Data were abstracted from records spanning 2020–2024 at the Career Institute of Medical Science & Hospital, Ghailla-Lucknow. Patients were categorized based on their baseline 25(OH)D levels, with Sufficiency (>30 ng/mL) serving as the reference group.4 The primary outcome was the count of AECOPDs requiring hospital admission in the 12 months following baseline assessment. Multivariate Cox Proportional Hazards Regression analysis was performed to estimate the adjusted Hazard Ratio (HR) for SVDD, controlling for established exacerbation risk factors including age, BMI, and GOLD E classification.6 Statistical analysis utilized IBM SPSS Statistics, Version 26.0 and R statistical software. Results: A profound deficiency was observed: 67.9% of the cohort had VDD (<20 ng/mL), with 30.2% specifically falling into the Severe VDD category (<10 ng/mL). The Severe VDD group reported a mean of 2.6 \pm 1.1 AECOPD hospitalizations per year, compared to 0.9\pm 0.5 in the Sufficiency group. Multivariate Cox regression analysis demonstrated that Severe VDD (<10 ng/mL) was an independent, statistically significant predictor of severe exacerbation risk (Adjusted HR: 2.85; 95% CI: 1.60–5.09; P < 0.001). The risk associated with Deficiency (10–20 ng/mL) did not reach statistical significance (HR: 1.55, P=0.114). Conclusion: Severe vitamin D deficiency is highly prevalent in this North Indian COPD cohort and constitutes a powerful, independent risk factor for frequent, severe exacerbations requiring hospital admission. These findings highlight the importance of routine 25(OH)D assessment and targeted nutritional intervention as an essential component of comprehensive COPD management in regions facing endemic VDD
ASSOCIATION BETWEEN SALIVARY CYTOKINES AND HISTOPATHOLOGICAL GRADES OF ORAL EPITHELIAL DYSPLASIA
Background: : Oral epithelial dysplasia (OED) represents a critical precursor stage in the development of oral squamous cell carcinoma, making early detection essential. Salivary cytokines have emerged as promising non-invasive biomarkers due to their ability to reflect underlying inflammatory and molecular changes within dysplastic tissues. Objective: To investigate the association between salivary cytokine levels and histopathological grades of oral epithelial dysplasia (OED), and to evaluate their potential role as non-invasive biomarkers for disease progression. Methods: This cross-sectional analytical study included patients clinically suspected of having oral potentially malignant disorders. Unstimulated saliva samples were collected prior to biopsy and analyzed for key pro-inflammatory cytokines, including interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α), using enzyme-linked immunosorbent assay (ELISA). Histopathological grading of OED was performed according to WHO criteria and categorized into mild, moderate, and severe dysplasia. Cytokine concentrations were compared across dysplasia grades, and correlations were assessed using appropriate statistical tests. Results: Mean salivary cytokine levels increased progressively with higher histopathological grades of OED. IL-6 and IL-8 showed a statistically significant association with dysplasia severity (p < 0.05), with the highest concentrations observed in severe dysplasia. TNF-α demonstrated a similar upward trend but did not reach statistical significance. Strong positive correlations were found between cytokine levels and histopathological grade, highlighting their potential role in reflecting epithelial alterations. Conclusion: Elevated salivary cytokines, particularly IL-6 and IL-8, are significantly associated with higher grades of oral epithelial dysplasia. These findings support the potential utility of salivary cytokine profiling as a non-invasive adjunctive tool for early detection, risk stratification, and monitoring of OED progression. Further longitudinal studies are warranted to validate their predictive value in malignant transformation.
Oral epithelial dysplasia, Salivary cytokines, Non-invasive diagnosis.
COMPARATIVE ASSESSMENT OF SCREW-RETAINED AND CEMENT-RETAINED IMPLANT RESTORATIONS: A CLINICAL STUDY AT FARYAL DENTAL COLLEGE, PAKISTAN
This study examines the frequency and factors inducing the use of screw-retained and cement-retained implant restorations among dentists in Faryal Dental College and compares these results with those from a similar study done in Saudi Arabia. Materials and Methods: Across Pakistan a five-page questionnaire was sent to private clinics and dental institutions. Descriptive statistics and Chi-square tests was used to analyzing data. Results: 120 surveys were distributed, but 90 were returned, giving a response rate of 75%. Cement-retained restorations were preferred by 73.3% of dentist, while 26.7% preferred screw-retained restorations. Resin-modified glass ionomer cement was the most used cement (46%), shadowed by resin cement (28%), conventional GIC (21%), and zinc phosphate (5%). Laboratory limits influenced the choice of retention system for 55.6% of respondents. Conclusions: In Pakistan, most dentists still prefer cement-retained restorations mainly because they are cheap and easier to manage in local laboratories. However, awareness about screw-retained options is gradually increasing, especially among younger dentists.
Implant Restorations, Comparative Assessment, screw-retained implant restorations, cement-retained implant restorations
SYNERGISTIC ANTIOXIDANT EFFECTS OF VITAMINS A AND E ON OXIDATIVE STRESS–INDUCED DAMAGE IN LUNG IMMUNE CELLS
Free radicals increase inflammation, reduce antioxidant defenses, and lead to oxidative stress, which is harmful to lung immunocytes. It is well-established that A and E vitamins are antioxidants. However, the extent of their synergistic protection is still unknown. Methodology: This HBS Medical and Dental College, Islamabad, research was conducted from June 2023 through June 2024. Seventy two samples were equally distributed into control, oxidative damage, and three treatment groups such that each group consisted of Vitamin A, Vitamin E, and both vitamins. The markers of oxidation relationship to stress and the activities of the antioxidant enzyme along with the inflammatory cytokines and cell viability were quantified in advance and following the treatment. Results: Cells exposed to oxidative injury showed a sharp rise in ROS, MDA, and inflammatory cytokines, along with a marked decline in antioxidant enzymes. Both vitamins improved these disturbances individually, but the combined treatment produced the strongest effect. The Vitamin A + E group had the lowest ROS and MDA levels, the highest SOD, CAT, and GPx activity, and the greatest improvement in cell viability with reduced apoptosis. The pattern indicated a synergistic benefit rather than a simple additive effect. Conclusion: The combination of vitamins A and E provide the most effective and significant oxygen radical and cell protection in respiratory immune cells. This indicates the potential importance for the development of combination strategies that utilize more than one antioxidant for the treatment of specific pulmonary disorders characterized by excessive oxidative stress.
Oxidative stress, Vitamin A, Vitamin E, lung immune cells, antioxidant enzymes, ROS, MDA, cytokines, cell viability.
TARGETED THERAPIES IN EYE DISEASES: ADVANCES IN PRECISION OPHTHALMOLOGY
Eye diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and inherited retinal disorders, are major causes of visual impairment and blindness worldwide. Traditional therapies often provide limited efficacy and carry systemic or local side effects. Recent advances in molecular biology and pharmacology have enabled the development of targeted therapies, which act on specific disease mechanisms, offering improved outcomes and personalized treatment strategies. Methodology: A comprehensive literature review was conducted focusing on molecular mechanisms underlying common ocular disorders and the development of targeted therapeutic interventions. Databases including PubMed, Scopus, and Web of Science were searched for studies on anti-VEGF therapy, gene therapy, neuroprotective agents, immunomodulatory drugs, and nanotechnology-based ocular drug delivery. Selected studies were analyzed for efficacy, safety, and clinical outcomes. Results: Targeted therapies demonstrated significant clinical benefits across multiple eye disorders. Anti-VEGF agents improved visual acuity and reduced neovascularization in AMD and diabetic macular edema. Gene therapy successfully restored partial vision in inherited retinal diseases like Leber congenital amaurosis. Neuroprotective and immunomodulatory agents preserved retinal function in glaucoma and uveitis, respectively. Nanotechnology-based drug delivery enhanced bioavailability and reduced treatment frequency. Overall, these therapies showed superior efficacy compared to conventional treatments with a reduced side-effect profile. Conclusion: Targeted medicine represents a transformative approach in ophthalmology, enabling precise, mechanism-based interventions that improve patient outcomes while minimizing systemic effects. Continued research in gene therapy, molecular pharmacology, and advanced drug delivery systems holds promise for the development of more effective and personalized ocular treatments.
Eye diseases, targeted therapy, anti-VEGF, gene therapy, neuroprotection, immunomodulation, precision medicine, ophthalmology
IMPACT OF ANATOMICAL DISSECTION EXPOSURE ON SALIVARY CORTISOL AND PERCEIVED STRESS IN MEDICAL AND DENTAL STUDENTS
Background: Cadaveric dissection remains a core aspect of medical and dental education, offering the invaluable three-dimensional anatomy. However, one can experience severe physiological and psychological stress when first subjected to preserved cadavers. This experiment had compared the changes in salivary cortisol and the perceived stress levels among the MBBS and BDS students during the first session of gross anatomy dissection study. Methods: A quasi-experimental observational study was conducted among 100 first year students (50 MBBS, and 50 BDS) of a teaching institution. Salivary cortisol and Perceived Stress Scale (PSS-10) scores were measured at two levels and these were measured at 15 minutes during entrance of the dissection hall (T1) and 15 minutes during completion of 90 minutes of a normal cadaveric dissection procedure (T2). Samples processing involved use of a high-sensitivity ELISA kit and PSS-10 scores were used to measure subjective stress. Paired t-tests, Wilcoxon test and correlation were used to analyze. Results: MBBS and BDS students had a noticeable increase in salivary cortisol after dissection (MBBS: 9.82 ± 2.15 to 14.26 ± 2.87 ng/mL; BDS: 10.11 ± 2.31 to 15.02 ± 3.01 ng/mL; p < 0.001 in both cases). Perceived stress also rose (MBBS: 15.4 +/- 4.2 to 21.1 +/- 4.9; BDS: 16.1 +/- 4.6 to 22.6 +/- 5.2: p < 0.001). Even though stress responses in BDS students were a bit higher, there were no significant differences between groups. The post-exposure cortisol and the PSS scores were found to be moderately positively correlated (r = 0.46, p < 0.001). Conclusion: Medical and dental students that are exposed to cadaveric dissection initially develop severe physiological and psychological stress. Cortisol rise being in line with perceived stress reflects the intensity of this early educational experience and also the necessity to implement structured preparatory and supportive approaches to facilitate student well-being and adaptive coping in anatomy education.
Cadaveric dissection; Salivary cortisol; Perceived stress; Medical students; Dental students; HPA axis; Anatomy education;