Patna Medical College and Hospital (abbreviated as PMCH) was established in 1925 and originally known as Prince of Wales Medical College, is a medical college located in Patna, the state capital of Bihar, India.It is located on the southern bank of the river Ganges and is now affiliated to Aryabhatta Knowledge University (previously: Patna University). The exact location is on Ashok Rajpath which is also home to other colleges of Patna University. It has more than 1748 beds which is at par with AIIMS. The emergency ward is called IGCE (Indira Gandhi Central Emergency) and has an additional 220 beds. It is one of the busiest hospitals in India. The average daily outpatient load is one of the highest in India.
BACKGROUND:Antiandrogen therapy is a cornerstone in managing female pattern hair loss (FPHL), yet comparative efficacy data between commonly used agents such as spironolactone and bicalutamide are limited. OBJECTIVES:To compare the efficacy and safety of bicalutamide (50 mg day-1) vs. spironolactone (100 mg day-1) monotherapy in women with FPHL. METHODS:This randomized, double-blind, parallel-group clinical trial was conducted at a tertiary care centre in India between February 2024 and March 2025. In total, 204 women aged 18-50 years with Sinclair grade II-V FPHL were randomized. Participants received either spironolactone 100 mg day-1 or bicalutamide 50 mg day-1 orally for 24 weeks. Trichoscopic assessments were performed at baseline and 24 weeks. Primary outcomes were changes in hair density and shaft diameter at two fixed scalp points [12 cm (frontal) and 24 cm (vertex) from the glabella]. Secondary outcomes included global photographic assessment, reduction in Sinclair hair shedding score and safety profile. The trial was registered with the Clinical Trials Registry of India (CTRI/2024/01/062101). RESULTS:Of 204 randomized participants, 188 (92.2%) completed the trial. The mean (SD) increase in hair count at the frontal site was 5.05 (3.61) hairs cm-2 in the bicalutamide group vs. 3.13 (2.62) hairs cm-2 in the spironolactone group [mean difference 1.92; 95% confidence interval (CI) 1.01-2.62; P < 0.001]. At the vertex site, the increase was 6.32 (9.38) vs. 3.06 (10.76) hairs cm-2, respectively (mean difference 3.26; 95% CI 0.35-6.08; P = 0.028). Hair shaft diameter increased more with bicalutamide at both sites [mean difference 2.87 μm; 95% CI 2.12-3.32 (frontal) and 2.10-3.36 μm (vertex); P < 0.001 for both]. Adverse events were reported in 18.6% of spironolactone-treated and 11.7% of bicalutamide-treated participants. CONCLUSIONS:Bicalutamide produced greater trichoscopic improvements than spironolactone; however, no significant between-group differences were observed in clinical endpoints. Limitations include a short follow-up period, single-centre design and per-protocol analysis, which may limit generalizability.
OBJECTIVES:Biologic DMARDs (bDMARDs) are widely used to treat moderate to severe PsA. TNF inhibitors (TNFi) are the most common initial biologic owing to their long market availability, clinician familiarity and lower cost. However, the optimal strategy following TNFi failure, cycling to another TNFi or swapping to a bDMARD with a different mechanism, remains uncertain. This meta-analysis compared the two strategies in these patients. METHODS:PubMed, Embase and Cochrane Central were searched for randomized controlled trials and observational studies comparing cycling with swapping in PsA. Outcomes included: (i) lack of response; (ii) 12-month retention; (iii) 24-month retention; and (iv) adverse events. Pooled risk ratios (RR) with 95% CI were calculated. RESULTS:Five observational studies, including 2300 PsA patients, were analysed; 1517 (66.0%) received cycling and 783 (34.0%) received swapping strategies. Disease duration before the second bDMARD ranged from 3.7 to 12 years. The main cause of discontinuation of the first TNFi before switching was lack of response (including primary non-response and secondary loss of response) according to individual study definitions. No significant differences were observed between groups for lack of response (RR 0.99; 95% CI 0.70-1.41; I2 = 92%), 12-month retention (RR 0.91; 95% CI 0.75-1.10; I2 = 79%), 24-month retention (RR 0.96; 95% CI 0.53-1.75; I2 = 94%) or adverse events (RR 0.94; 95% CI 0.38-2.34; I2 = 71%). CONCLUSION:Following TNFi failure, cycling and swapping strategies show comparable retention and safety, suggesting that treatment choice may be guided by clinical characteristics and patient preference rather than clear differences in overall effectiveness.
The magnetic field-assisted finishing (MFAF) experimental process, using a medium of magnetorheological fluids (MRF), improves the surface quality. The response surface methodology Box-Behnken design (RSM-BBD) was used for this investigation. Consequently, the BBD model was chosen to optimize the input parameters, such as the polishing tool speed, surface finishing time, and gap between workpiece-too surface, which significantly influence the surface roughness. The author examined how these surfaces characteristics affect the input process parameters. The novelty lies in the MFAF finishing process for bio-zirconium alloys, which utilizes different toolpaths, parallel and spiral toolpaths for nano-level surface finishing. The surface roughness was reduced by 97.22
Background: Oligohydramnios, defined as a reduced volume of amniotic fluid, is a common obstetric complication associated with adverse maternal and perinatal outcomes. It is commonly diagnosed by ultrasonography using the amniotic fluid index (AFI) of ≤5 cm or a single deepest pocket of <2 cm. Oligohydramnios has been linked to increased rates of labor induction, cesarean delivery, fetal distress, meconium-stained liquor, low birth weight, and neonatal morbidity. Objectives: To evaluate the maternal and perinatal outcomes in pregnancies complicated by oligohydramnios and to assess its impact on the mode of delivery and neonatal outcome. Materials and Methods: A prospective observational study was conducted among 100 pregnant women with singleton pregnancies diagnosed with oligohydramnios after 37 weeks of gestation. Detailed obstetric history, clinical examination, and ultrasonographic assessment were performed. Maternal outcomes including mode of delivery and intrapartum complications were recorded. Perinatal outcomes such as birth weight, Apgar score, meconium-stained liquor, NICU admission, and perinatal mortality were analyzed. Results: The majority of patients were primigravidae and presented at term. Labor induction was required in a significant proportion of cases. Cesarean section rates were increased, predominantly due to fetal distress. Meconium-stained liquor was observed frequently. A considerable number of neonates had low birth weight and low Apgar scores at 5 minutes. NICU admissions were higher among neonates born to mothers with severe oligohydramnios. Perinatal morbidity was increased, although perinatal mortality remained low with timely obstetric intervention. Conclusion: Oligohydramnios is associated with increased maternal interventions and adverse perinatal outcomes. Early diagnosis, close fetal surveillance, and appropriate obstetric management can significantly improve neonatal outcomes and reduce complications. Careful monitoring of pregnancies complicated by oligohydramnios is essential to ensure favorable maternal and perinatal outcomes.
Background: Megaloblastic anemia is a major cause of macrocytic anemia worldwide and is particularly common in developing countries due to nutritional deficiencies. In India, dietary practices, socioeconomic factors, and gastrointestinal disorders contribute significantly to deficiencies of vitamin B12 and folate. These deficiencies lead to impaired DNA synthesis and ineffective hematopoiesis, resulting in characteristic hematological abnormalities including macrocytosis and pancytopenia. Objective: To determine the incidence and evaluate the hematological profile of megaloblastic anemia among adult patients attending a tertiary care hospital in eastern India. Materials and Methods: A hospital-based descriptive observational study was conducted in the Department of Pathology at Patna Medical College and Hospital, Patna, India, over a period of 9 months from March 2025 to November 2025 A total of 100 adult patients aged 18–70 years diagnosed with megaloblastic anemia were included. Clinical details and hematological parameters were analyzed. Complete blood counts and red cell indices were obtained using an automated hematology analyzer, and peripheral blood smears stained with Leishman stain were examined for morphological abnormalities. The severity of anemia, presence of cytopenias, and etiological distribution of vitamin deficiencies were evaluated using descriptive statistical methods. Results: The majority of patients were in the 31–40-year age group (32%), with a slight male predominance (58%). Vitamin B12 deficiency was the most common etiological factor, accounting for 64% of cases, followed by combined vitamin B12 and folate deficiency (21%) and isolated folate deficiency (15%). Moderate anemia was observed in 44% of patients, while severe anemia was present in 32%. The mean hemoglobin level was 8.4 ± 2.1 g/dL and the mean corpuscular volume was 108.6 ± 9.3 fL. Pancytopenia was observed in 28% of patients and bicytopenia in 36%. Peripheral smear examination revealed macro-ovalocytes in 82% of cases and hypersegmented neutrophils in 76%, confirming typical megaloblastic morphological features. Conclusion: Megaloblastic anemia remains a common and preventable hematological disorder among Indian adults, with vitamin B12 deficiency representing the predominant cause. Routine hematological evaluation, particularly assessment of red cell indices and peripheral smear morphology, plays a crucial role in early diagnosis and management, thereby preventing potential complications.
