Sher-i-Kashmir Institute of Medical Sciences, often abbreviated as SKIMS, is the largest medical Institute under State Legislature Act in the Indian union territory of Jammu and Kashmir.SKIMS is the only medical university of the union territory of J&K, headed by a Director who is also the Ex-officio Secretary to the Government.Lieutenant Governor J&K is the Chairperson of the SKIMS governing body that performs the role of the cabinet for the semi-autonomous super-speciality hospital and the deemed university. In addition to the deemed university and the main hospital, the institute comprises the State Cancer Institute, Maternity Hospital, Nursing college, Paramedical college, and an affiliated medical college & hospital which is on the city outskirts at Bemina.
Polycystic ovary syndrome (PCOS) is a multifaceted reproductive and endocrine health issue affecting reproductive aged women, characterized by insulin resistance (IR), chronic low-grade inflammation (LGI), oxidative stress (OS) and dysregulated WNT/β-catenin signaling pathway. Although a part of the involved mechanism in PCOS occurrence is discovered, the exact etiology involving intricate relationships between OS, inflammatory markers and dysregulated WNT/β-catenin signaling pathway in PCOS are still unknown. This review aimed to explore the interplay between IR, LGI, OS and dysregulated WNT/β-catenin signaling pathway in the pathophysiology of PCOS. A comprehensive literature search was conducted to identify relevant studies investigating the role of OS, inflammatory markers and WNT/β-catenin signaling in PCOS. Databases including PubMed, Scopus, Web of Science and Google Scholar were searched using keywords as, "PCOS and oxidative stress", "Insulin Resistance and PCOS", "Inflammation and PCOS", "WNT/β-catenin signaling in PCOS". The search was limited to studies published in English up to 2025 without any restrictions on publication year. In conclusion, PCOS is a complex and multifactorial disorder driven by the intricate involvement of insulin resistance, chronic low-grade inflammation, oxidative stress and dysregulated WNT/β-catenin signaling pathway among reproductive age women. Although substantial progress has been made in elucidating these interconnected mechanisms, the etiological pathways remain incompletely understood. The evidences collected in this study highlights that these physiological and signaling factors do not act in isolation but collectively contribute to the initiation and progression of various pathological mechanisms of PCOS among young women. A deeper understanding of their physiological and molecular crosstalk is essential for identifying reliable biomarkers and novel therapeutic targets.
The protrusion of abdominal contents into the thoracic cavity through a defect in the diaphragm is known as a diaphragmatic hernia. It can be either congenital or acquired with congenital cases often diagnosed prenatally and repaired shortly after birth. Diagnosing an adult diaphragmatic hernia can be difficult because the condition may stay asymptomatic or exhibit unusual and unrelated symptoms. Acquired diaphragmatic hernias are more common in adults, with trauma, both blunt and penetrating, as the primary cause. High clinical suspicion is essential, and prompt radiological investigation is crucial for accurate diagnosis. Early diagnosis and appropriate surgical intervention are essential for optimal outcomes. In the present article, two cases of adult diaphragmatic hernias are described. The first case presented with herniation of small gut loops into the left hemithorax in a 29-year-old woman. The second case was with a giant diaphragmatic hernia containing the spleen, stomach, small gut, and large gut loops and a part of the liver masquerading as tension pneumothorax in a 30-year-old woman (Gastrospleenothorax). Both cases were diagnosed and managed successfully via laparoscopic repair. This report, along with a review of the literature, highlights the unusual presentation of diaphragmatic hernias in adults and demonstrates the feasibility of laparoscopic repair.
BACKGROUND:Q fever is an underrecognised zoonosis with significant global and regional variation. Data on its burden in North India are limited. This study aimed to determine the frequency and clinical profile of Q fever among patients presenting with acute febrile illness in a tertiary care hospital in Kashmir. METHODS:A hospital-based study was conducted over 18 months in which patients with fever ≤3 weeks were enrolled after excluding other defined infections. Serum and whole blood samples were tested for Coxiella burnetii using enzyme-linked immunosorbent assay (ELISA) for phase I/II immunoglobulin M (IgM) and IgG antibodies and conventional polymerase chain reaction (PCR) targeting the IS1111a gene. Demographic and clinical data were analysed using SPSS version 22.0 and R software, with statistical significance set at p<0.05. RESULTS:Of 96 patients, 15.6% were positive by ELISA, PCR or both. The highest positivity occurred in the 31-40 y age group (45%; p=0.002). The Ganderbal (35.3%) and Srinagar (18.5%) districts showed the highest prevalence (p=0.043). Significant association was observed with a shorter hospital stay (p<0.001). IgG phase II ELISA demonstrated better sensitivity (50%) than IgM phase II ELISA (25%), while PCR provided early detection. CONCLUSIONS:A frequency of 15.6% for Q fever was observed, especially in the adult age group. PCR outperformed serological assays in early detection, while IgM phase II ELISA showed poor sensitivity. Strengthened clinical suspicion, enhanced diagnostic capacity and integrated One Health surveillance are essential for effective control.
Pelviureteric junction obstruction (PUJO) is the most common cause of pediatric hydronephrosis; however, distinguishing obstructive and non-obstructive dilatation remains challenging. Existing diagnostic modalities are limited by the lack of validation against objective measures of renal injury. Preoperative imaging is critical for guiding surgical decision-making; however, its correlation with histopathologic renal damage has not been fully elucidated. To evaluate the association between preoperative sonographic and nuclear scintigraphy parameters and intraoperative renal histopathology in children with congenital PUJO and to identify imaging predictors of significant renal parenchymal damage. A prospective observational study was conducted on 60 children (< 16 years) with unilateral PUJO who underwent Anderson–Hynes pyeloplasty. Preoperative ultrasound parameters, including Society for Fetal Urology (SFU) grade, anterior–posterior pelvic diameter (APD), cortical thickness, and Doppler resistive index (RI), as well as nuclear scintigraphy parameters, including differential renal function (DRF), drainage half-time (T½), and renogram curve were recorded. Renal lower pole cortical biopsies were graded using Elder’s histopathology scoring system, with significant histologic damage defined as moderate-to-severe injury (score of ≥ 6). Statistical correlations and receiver operating characteristic analyses were performed to assess the predictive value of imaging parameters for histologic injury. High-grade hydronephrosis (SFU grade III–IV) was observed in 70.0
Background: Heart failure (HF) is a complex clinical condition requiring resource-intensive management and substantial health expenditure. The adverse economic impact of medical care on patients or financial burden is increasingly recognised as a significant non-clinical entity affecting HF management in low-and middle-income countries (LMIC). We explored the factors associated with Financial Burden (FB) in HF patients in India. Methods: We recruited HF patients from 21 hospitals across India, selected to reflect regional diversity and varying stages of epidemiological transition. Trained personnel collected clinical and economic data using a validated and structured questionnaire. Expenditures were recorded in Indian rupees (INR) and converted to international dollars (INT$). Results: We recruited 1,859 participants. Nearly one-third of participants (30.2%) were women. The mean age was 55.9 (11.3) years, and the mean duration of formal education was 11.3 (3.8) years. Health insurance coverage was reported in one-third (32.2%) of the study population. The average annual out-of-pocket (OOP) expenditure was INR 1,06,566 (INT$ 4,709.10), constituting 92.6% (95% CI: 92.5-92.7) of the total health expenditure. Compared to the previous year, a decline in monthly income was reported by 32.3% of individuals and 36.2% of households. Catastrophic health spending (CHS) and distress financing (DF) were observed in 37.7% (35.5-39.9) and 17.7% (15.9-19.4) of the households, respectively. However, CHS and DF were lower [30.8% (26.2-35.4) and 13.6% (10.2-17.0), respectively] among those with health insurance compared to the uninsured [40.3% (37.6-43.0) and 18.9% (16.7-21.1), respectively]. Conclusion: Seven out of 10 HF patients in India lack financial health protection. OOP expenditures, accounting for over 90% of total health spending, contribute significantly to economic distress in HF patients. Financial burden, affecting more than one-third of HF patients, carries profound implications for individual well-being. Addressing this financial burden, including CHS and DF, is essential for improving clinical outcomes and ensuring health equity.
