M. P. Shah Medical College, Jamnagar (also Shri M. P. Shah Medical College) is a medical college in Jamnagar, Gujarat, India. It is associated with the Guru Gobindsingh Hospitals, the second largest hospital complex in the state of Gujarat. The college is notable for having a solarium. P. P. P.
Background: Mental disorders are a major contributor to the burden of disease in India, with regional differences in prevalence, severity, and coverage of services. The need for planning at the national level based on standardized disease metrics remains unsatisfactory. Aim: The aim of this study was to assess and compare the prevalence and severity of major mental health disorders across Indian states and union territories (UTs) utilizing data from the Global Burden of Disease (GBD) 2021. Methods: We performed a cross-sectional ecological study of GBD 2021 data focusing on four primary disorders (depression, anxiety, bipolar disorder, and schizophrenia) throughout 36 states and UTs. Disability-adjusted life years (DALYs) and prevalence rates were standardized for every 100,000 individuals using estimates from the 2021 census. We introduced an innovative Per-Case Disability Index (DALYs/prevalence) to evaluate disability on a per-case basis. Correlation analyses and regional comparisons were carried out, incorporating analysis of variance and a Gender Disparity Index (GDI). Results: Depressive disorders showed the highest average burden (mean DALY: 827.7/100,000), followed by anxiety (474.5), schizophrenia (213.2), and bipolar disorder (77.4). Schizophrenia had the highest Per-Case Disability Index (mean: 0.637). There was a significant relationship ( r > 0.99) between DALYs and prevalence. High Per-Case Disability Index values were found in smaller states such as Tripura, Manipur, and UTs (apart from Delhi). Conclusion: Prevalence and severity of mental health disorders differ significantly across various regions in India. DALY, prevalence data along with Per-Case Disability Index, can help in developing equitable policy. Integrating Per-Case Disability Index and GDI into planning may enable more equitable resource distribution.
Background: Pleural effusion is a prevelant complication of multiple pathologies leading to annual incidence of 3000 cases per million. The delay in diagnosing the cause of pleural effusion and treatement of the underlying cause is the major factor of mortality. Objectives: The study aims to establish the accuracy of pleural pro-Bnp in evaluating the cardiac causes of pleural effusion,. Methods: The study evaluates the level of pro-BNP measured in cardiac and non cardiac causes to identify its role in diagnosing the cause of effusion. Results: Pro-BNP levels are significantly lower in patients with pleural effusion due to hepatic hydrothorax which is 84% lower than the referral level of cardiac causes with a base value of >1714pg/ml, 94 % less in patients with tuberculosis related pleural effusion and 91% less in parapneumonic and 78% lower in effusion due to malignant causes of pleural effusion. hence showing the tests accuracy in distinguishing cardiac from non cardiac causes of pleural effusion Conclusion: Pro BNP levels can aid in distinguishing cardiac from non cardiac causes of pleural effusion. Early detection of cause with accuracy can help in early treatment and low mortality.
Endocrinology has evolved from a discipline based on hormone replacement and biochemical diagnosis into a precision, technology-driven specialty. This chapter summarizes recent advances in diagnostic, therapeutic and digital technology which collectively are changing the management of diabetes mellitus, thyroid disease, pituitary and adrenal disorders and metabolic bone disease. Next-generation sequencing raised the diagnostic yield of monogenic diabetes by about 30% over sequential Sanger sequencing used in diagnostics, while circulating microRNAs, liquid biopsy and multiplex spatial profiling allowed earlier, minimally invasive detection of endocrine neoplasms. Combined elastography and conventional ultrasonography had pooled sensitivity and specificity > 85% for risk stratification of thyroid malignancy, and novel radiotracers improved localization of neuroendocrine, parathyroid and adrenal lesions. Therapeutically, dual incretin agonism with tirzepatide reduced glycated hemoglobin by up to 2.46% and weight by >12 kg, sodium–glucose cotransporter-2 inhibitors reduced heart failure hospitalization by 30–40%, and disease-modifying agents such as teprotumumab, osilodrostat and crinecerfont redefined care in thyroid eye disease, Cushing disease, and congenital adrenal hyperplasia, respectively. More improvements came from automated insulin delivery, modified-release hydrocortisone and artificial-intelligence-assisted imaging and pathology. The major novelty of this synthesis is that it demonstrates how genomic, biomarker, imaging, pharmacologic and digital innovations now converge into one closed-loop, algorithm-supported model of care, from bioelectronic neuromodulation to digital-twin simulation, rather than proceeding forward as isolated advances. This convergence heralds a real shift from reactive, symptom-driven management to predictive, preventive, personalized and participatory (P4) endocrine care, with immediate implications for clinical practice, health-system design and future translational research.
Background : Extrapulmonary tuberculosis (EPTB) remains a major public health challenge because of its atypical presentation, paucibacillary nature, and diagnostic difficulties. The emergence of drug-resistant EPTB (DR-EPTB) further complicates management and threatens tuberculosis control programs. Limited data are available from Western India regarding molecular epidemiology and resistance patterns of EPTB. This study evaluated the distribution, yield, and resistance patterns with molecular and culture-based methods. Methods A cross-sectional study was conducted at an Reference Laboratory in Western India from January 2024 to December 2025. A total of 6,068 suspected EPTB samples were analyzed using CBNAAT, liquid culture (MGIT), solid culture (LJ), and line probe assays (LPA). Drug susceptibility testing was performed using FL-LPA, SL-LPA, and MGIT 960 where indicated. Statistical analysis was performed using Jamovi software with p < 0.05 considered significant. Results : Of 6,068 samples, 997 (16.43%) were CBNAAT positive. Highest positivity was observed in pus aspirates (35.3%) followed by lymph node samples (20.36%). Overall culture positivity was 3.80%, while positivity among CBNAAT-positive samples was 23.16%. Males constituted 56.36% of cases, and the most affected age group was 21–40 years. Drug resistance was detected in 6.11% cases, with RR-TB being most common (65.57%), followed by isoniazid mono-resistance (16.39%) and MDR-TB (6.55%). Common mutations included rpoB D516V, katG S315T1, inhA C-15T, and gyrA A90V. CBNAAT semi-quantitative grading correlated with culture positivity (p < 0.001). Conclusions : EPTB in Western India shows a substantial burden of drug resistance. molecular diagnostics are crucial for early detection and resistance profiling, highlighting the need for universal DST and surveillance systems.
Background: Renal cell carcinoma (RCC) is a common malignancy of the urinary system, and radical nephrectomy is an important treatment option for selected patients with unilateral disease. However, removal of the affected kidney reduces functional renal mass and may lead to postoperative renal impairment. Tumor size may influence postoperative renal outcomes, making it important to evaluate changes in renal function following surgery. Aim: To observe the impact of tumor size on postoperative renal function following radical nephrectomy in patients with unilateral renal cell carcinoma. Methods: A hospital-based observational study included 150 patients with unilateral renal cell carcinoma who underwent radical nephrectomy. Patients were categorized into Group A (tumor size ≤7 cm; n=75) and Group B (tumor size >7 cm; n=75). Demographic characteristics, tumor histology, serum creatinine and estimated glomerular filtration rate (eGFR) were assessed. Renal function was compared preoperatively and at one and six months after surgery. Results: The analysis of 150 patients showed that clear cell renal cell carcinoma was the predominant histological subtype in both groups. Median eGFR decreased at one month after radical nephrectomy and subsequently improved at six months in both groups. At one month, median eGFR was 58.00 mL/min/1.73 m² in Group A and 66.00 mL/min/1.73 m² in Group B, increasing to 65.00 and 72.50 mL/min/1.73 m², respectively, at six months. The percentage changes in eGFR were greater in Group A than Group B at both follow-up intervals. Conclusion: Renal function declined at one month after radical nephrectomy and partially recovered by six months in both tumor-size groups. Postoperative median eGFR was higher in patients with tumors larger than 7 cm. These observational findings did not establish tumor size as an independent determinant of postoperative renal function.
