Indira Gandhi Institute of Medical Sciences, an Institute under State Legislature Act (Government), was established on 19 November 1983 as an autonomous organisation on the pattern of All India Institute of Medical Sciences, New Delhi. The estimated budget was 110 crore rupees which was later revised to 133 crores. It is one of the main health care institutions in the state of Bihar. It is the only superspecialist institute of Bihar and tops the hierarchy in patient referral chain. The institute provides education in medicine and does conducts many health and medicinal research in Bihar. It received affiliation of medical college from MCI in September 2011. It has 120 recognised MBBS seats and the highest number of superspeciality seats among the colleges of Bihar.It is recognised to provide degree of MBBS, MD, MS, M.Ch, DM, DNB, Ph.D. and various paramedical degrees.The whole medical college and hospital campus is spread over an area of 131 acres. The hospital is proposed to have 2500 beds in the coming few years. At present, there are nearly 1070 beds present. Construction is ongoing of another 500-bed ultra modern hospital, 100-bed Regional Cancer Center, and 200-bed Regional Institute of Ophthalmology.
Chronic low back pain (CLBP) is a leading cause of pain and disability worldwide. Most cases are nonspecific, lacking a clear pathological cause, and management remains challenging. Botulinum toxin type A (BoNT-A), a neurotoxin that blocks acetylcholine release and reduces muscle hyperactivity, has been studied in CLBP with inconsistent results. This meta-analysis aimed to determine the efficacy of BoNT-A compared with placebo or saline in the management of nonspecific CLBP. A comprehensive search of PubMed, Embase, Cochrane Library, and the WHO ICTRP databases was conducted for randomized controlled trials (RCTs) involving adults with nonspecific CLBP who received BoNT-A or placebo injections and were registered in PROSPERO (CRD42024559735). The primary outcome was pain response, defined as a ≥ 50
Integrating language models (LMs) in healthcare systems holds great promise for improving medical workflows and decision-making. However, a critical barrier to their real-world adoption is the lack of reliable evaluation of their trustworthiness, especially in multilingual healthcare settings. Existing LMs are predominantly trained in high-resource languages, making them ill-equipped to handle the complexity and diversity of healthcare queries in mid- and low-resource languages, posing significant challenges for deploying them in global healthcare contexts where linguistic diversity is key. In this work, we present \textsc{Clinic}, a \textbf{C}omprehensive Mu\textbf{l}tilingual Benchmark to evaluate the trustworth\textbf{i}ness of la\textbf{n}guage models \textbf{i}n health\textbf{c}are. \name systematically benchmarks LMs across five key dimensions of trustworthiness: truthfulness, fairness, safety, robustness, and privacy, operationalized through 18 diverse tasks, spanning 15 languages (covering all the major continents), and encompassing a wide array of critical healthcare topics like disease conditions, preventive actions, diagnostic tests, treatments, surgeries, and medications. Our extensive evaluation reveals that LMs struggle with factual correctness, demonstrate bias across demographic and linguistic groups, and are susceptible to privacy breaches and adversarial attacks. By highlighting these shortcomings, \name lays the foundation for enhancing the global reach and safety of LMs in healthcare across diverse languages.
Background: Birth weight is the critical determinant of neonatal survival, with deviations from the norm increasing the risks of perinatal morbidity and mortality. Accurate estimation of fetal weight is essential for effective management during labor, particularly in high-risk pregnancies. Clinical and sonographic methods are the primary techniques for estimating fetal weight, with each method showing distinct advantages and limitations. Objective: This study aims to compare the accuracy of clinical (Insler’s formula) and sonographic (Hadlock’s formula) methods in estimating fetal weight, by correlating these estimates with actual birth weight. Materials and Methods: A prospective observational study was conducted, including 100 antenatal cases with term singleton pregnancies. Clinical assessments were performed using Insler’s formula, while ultrasound-based fetal weight estimation was done using Hadlock’s formula. Birth weight was recorded post-delivery, and statistical analysis was performed to assess correlations and agreement. Results: The mean fetal weight estimated by Insler’s formula was 3.23 ± 0.42 kg, and by Hadlock’s formula was 3.16 ± 0.44 kg. The actual birth weight averaged 3.06 ± 0.42 kg. Both methods showed fair agreement with actual birth weight, with Cohen’s kappa values of 0.274 (Insler’s) and 0.167 (Hadlock’s), indicating statistically significant agreement in the Insler’s formula group (P < 0.001) but not in the Hadlock’s formula group (P = 0.089). Conclusion: Both clinical and sonographic methods demonstrate fair agreement with actual birth weight, but clinical method (Insler’s formula) is more accessible, cost-effective, and accurate for fetal weight estimation in low-resource settings. This study suggests that clinical methods can be reliably used in managing labor and delivery in resource-limited environments.
Carbapenemes are most powerful antibiotics available for the treatment of bacterial infections. However, bacteria have evolved the enzyme carbapenemase, specifically the New Delhi metallo-β-lactamase (NDM-1), hydrolyses broad spectrum of β-lactam antibiotics, including carbapenems, the last line of defense against infections, thus raising a significant global health issue. Hence, NDM-1 is a promising drug target against antibiotic resistance. A structure-based in silico approach employed to identify potential inhibitors of NDM-1. Virtual screening of 13,526 antibacterial compounds yielded ten candidates with the most favorable binding affinities (− 9.50 to − 8.07 kcal/mol), outperforming the reference ligand 7UOX-Lig (− 5.81 kcal/mol). Molecular dynamics simulations confirmed the stable binding of compounds 11,871, 12,801, 13,206, and 12,498, further supported by favorable MM/GBSA binding free energy values and consistent interaction profiles. The favorable thermodynamic profiles suggest that these compounds are promising NDM-1 inhibitors. They serve as potential leads for further optimization and experimental validation in developing novel therapeutics against NDM-1–mediated antibiotic resistance. Further in vitro and biochemical studies are warranted to confirm their efficacy and specificity, emphasizing the critical role of NDM-1 as a key target in combating β-lactam resistance.
Background: Constipation is one of the most common gastrointestinal disorders encountered in tertiary care settings and significantly affects quality of life across all age groups. Multiple classes of laxatives are available for treatment, including bulk-forming agents, stool softeners, osmotic purgatives, stimulant purgatives, and newer prokinetic agents. However, prescribing practices often vary due to clinician preference, availability, cost, and pharmaceutical promotion rather than objective comparison of efficacy, safety, convenience, and affordability. The concept of personal formulary (P-drug) development encourages rational and evidence-based selection of medicines. Aim: To develop a personal formulary for constipation using the P-drug concept among residents of Pharmacology in a tertiary care setting. Materials and Methods: This study was conducted in the Department of Pharmacology of a tertiary care teaching hospital. The P-drug for constipation in adults was selected using the WHO 6-step approach. Drugs from commonly used laxative groups available under the Janaushadhi scheme were evaluated, including Lactulose syrup, Lactitol and Ispaghula, Bisacodyl tablet, Liquid paraffin & Milk of Magnesia & Sodium Picosulphate suspension, Magnesium hydroxide & Aluminum hydroxide & Dimethicone tablet and Prucalopride tablet. Drugs were compared based on four parameters: efficacy, safety, cost, and convenience according to the P-drug concept of Joshi and Jayawick Ramarajah. Scores were given to each four parameters from 1 to 10 for each drug. Each parameter was given a fractional numerical rating (β) according to the importance i.e. 0.4 for efficacy, 0.3 for safety, 0.2 for cost and 0.1 for convenience. The total weighted score was calculated for each drug, and the highest-scoring drug was selected as the personal formulary drug. Results: Among the evaluated drug groups, Osmotic purgatives achieved the highest score of 8.3 followed by bulk forming agents. Among the osmotic purgatives, Lactulose syrup achieved the highest total score (8.0), followed by Lactitol and Ispaghula combination (7.6) and Magnesium hydroxide & Aluminium Hydroxide & Dimethicone tablet. Though Ispaghula as a standalone formulation is not available in Janaushadhi, it’s high safety and efficacy profile has influenced its comparison with Lactulose where it scored 8.3 but amongst the drugs available under Janaushadhi, Lactulose demonstrated good efficacy, favorable safety profile, reasonable cost, and excellent convenience, making it the preferred P-drug for constipation. Conclusion: By applying rational drug selection principles with greater emphasis on efficacy and safety, Lactulose syrup emerged as the most suitable personal formulary drug for constipation. The structured evaluation enhanced critical appraisal skills among residents and promoted safe, effective, convenient, and economical prescribing practices in routine clinical care. Keywords: Constipation, P-drug, Lactulose, Rational drug use, Laxatives, Personal formulary.
