Madhubani Medical College and Hospital is a government Medical college in Madhubani, Bihar..
Background: After 34 weeks, breech presentation frequently leads to a high rate of cesarean section (about 65%–96%), since this is the recommended approach to reduce neonatal morbidity and mortality when compared to vaginal breech delivery, especially in preterm or complex cases. The purpose of this study is to assess the delivery route, mother outcomes, and perinatal outcomes in cases of singleton breech presentation that occur after 34 weeks of gestation. Results of breech presentation following 34 weeks of pregnancy. Method: The Department of Obstetrics and Gynecology at Madhubani Medical College and Hospital in Madhubani, Bihar, conducted a prospective observational study between January and December of 2025. A total of 225 cases of breech presentation after 34 weeks were included in this study. When appropriate, an external cephalic version was performed. Data on the mode of delivery, maternal outcomes, and neonatal outcomes were gathered and analyzed while these patients were monitored until delivery. Result: Breech presentation at term was 3.24% (154 cases out of 4745 deliveries); primigravida women made up 45.3% of these cases, while multigravida women made up 54.7%. A considerable percentage of instances, or 71 out of 225 (31.5%) women, showed spontaneous cephalic version. With a success rate of 59%, the external cephalic version was effective in 17 out of 29 cases. 147 cases (65%) of breech presentations were delivered via cesarean section, while the remaining 78 cases (35%) were delivered vaginally, including six cases of assisted breech deliveries. Conclusion: Even in the late third trimester, a considerable proportion of breech fetuses undergo spontaneous version. An efficient method for lowering the incidence of cesarean deliveries in singleton pregnancies with breech presentation is external cephalic version.
Background: Pigmentary disorders are common dermatological conditions resulting from abnormalities in melanin production or distribution. In India, these disorders represent a significant proportion of dermatology outpatient visits and can have considerable psychosocial impact due to their visible nature. Aim: To evaluate the clinical and epidemiological profile of pigmentary disorders among Indian patients attending a dermatology outpatient department. Methodology: A cross-sectional observational study was conducted for one year in the Department of Skin and VD at Darbhanga Medical College and Hospital, Bihar, India. A total of 160 patients with clinically diagnosed pigmentary disorders were included. Demographic data, clinical history, and risk factors were recorded using a structured proforma. Dermatological examination was performed, and data were analyzed using SPSS version 25. Results: The mean age of participants was 36.8 ± 10.1 years, with females constituting 62.5% of cases. The most common pigmentary disorder was melasma (34.4%), followed by post-inflammatory hyperpigmentation (23.8%) and vitiligo (18.8%). Facial involvement was the predominant clinical presentation across most conditions. Average daily sunlight exposure among participants was 4.0 ± 1.4 hours. Conclusion: Pigmentary disorders are prevalent among dermatology OPD patients, particularly among females, with melasma being the most common condition. Facial involvement and significant sun exposure were frequent findings, highlighting the need for early diagnosis, patient education, and appropriate management.
Background: There are several methods to estimate time since death, but no method, used singly, is totally reliable. After death, several morphological changes occur in all the cellular components of blood, including the white blood cells. Aim of this study to correlated between the times since death with morphological changes in neutrophils. Methods: In this study morphological changes in neutrophils were studied in autopsy cases. Blood samples from 57 different autopsy cases were taken and smears were prepared after staining them with Leishman stain. The samples were examined using light microscope under 40X and 100X magnification. Results: Among 57 cases no degenerative changes were seen in 8. Mild degenerative changes were seen in among 23, Moderate among 12 and Marked among 14 cases. Among 57 cases while observing degenerative changes in neutrophils nuclear changes were seen in 47 cases in form of pyknosis among them 40 reached to level of nuclear fragmentation. Cytoplasmic changes were seen in form of cytoplasmic vacuolation seen in 49 cases. Among them loss of cytoplasm was seen in 36 and cytoplasmic degeneration seen in 26. There was only 8 case in which no change was seen. No changes were seen upto 6 hrs. Conclusion: The present study proves that changes in the morphology of neutrophils can be helpful as supplementary procedure for estimating time since death.
Background: Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide. Early identification of severe cases is essential for timely intervention and improved outcomes. Serum biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), neutrophil-to-lymphocyte ratio (NLR), and serum lactate have emerged as valuable tools for assessing disease severity. Aim: To evaluate the role of serum biomarkers in predicting the severity of community-acquired pneumonia and their correlation with established clinical severity scores. Methods: A prospective observational study was conducted among 100 patients diagnosed with CAP admitted to Madhubani Medical College and Hospital, Madhubani, between April 2025 and January 2026. Serum CRP, procalcitonin, NLR, and lactate levels were measured at admission. Severity was assessed using CURB-65 and Pneumonia Severity Index (PSI) scores. Biomarker levels were compared between severe and non-severe CAP groups. Results: Among 100 patients, 62% were males and 38% females. Thirty-five patients had severe CAP. Mean CRP, PCT, NLR, and lactate levels were significantly higher in severe CAP compared to non-severe CAP (p<0.001). Procalcitonin demonstrated the highest predictive accuracy for severe disease (AUC=0.89), followed by lactate (AUC=0.86), CRP (AUC=0.83), and NLR (AUC=0.80). Conclusion: Serum biomarkers, particularly procalcitonin and lactate, are valuable predictors of CAP severity and correlate strongly with clinical severity scores. Their incorporation into routine assessment may facilitate early risk stratification and optimize patient management. Recommendation: Routine assessment of procalcitonin and serum lactate, alongside conventional severity scores, is recommended for early risk stratification and identification of patients requiring intensive monitoring and aggressive management.
