Shri B. M. Patil Medical College

Women experiencing labor pain undergo significant psychological and physiological challenges, often leading to increased rates of cesarean sections. Epidural analgesia has proven effective in managing labor pain, but its efficacy varies among individuals, partly due to genetic differences, including variations in the COMT gene, which influences pain perception pathways. Fifty-three hospitalized patients provided informed consent to participate in this study. Peripheral venous blood samples were collected in EDTA tubes for DNA isolation and Polymerase Chain Reaction (PCR) analysis to investigate COMT gene polymorphisms. Epidural analgesia (Fentanyl with Ropivacaine) was administered upon reaching regular uterine contractions and cervical dilation of 4–5 cm. Pain and anxiety levels were assessed using the Visual Analog Scale (VAS) and State Anxiety Inventory (SAI) at predetermined intervals post-administration. Data analysis focused on exploring associations between COMT gene variants and outcomes related to pain perception and anxiety during labor. Of the 53 participants, 35 were homozygous for the wild-type genotype (Val/Val). Approximately 33.9

INTRODUCTION:Labour is a critical physiological process requiring close monitoring to ensure optimal maternal and neonatal outcomes. Traditional labour monitoring using the WHO Modified Partograph has been widely adopted; however, concerns regarding rigid time thresholds and unnecessary interventions have prompted the development of the WHO Labour Care Guide (LCG), a more individualized and woman-centred tool aligned with contemporary evidence. Comparative data between these two tools remain limited. The study aimed to compare the effectiveness of the WHO LCG with the WHO Modified Partograph in terms of maternal labour outcomes and caesarean section rates among primigravida women at term. METHODS:This comparative observational study was conducted at a tertiary care teaching hospital in South India. A total of 146 primigravida women in spontaneous labour with singleton, cephalic pregnancies at 37-40 weeks of gestation were enrolled. Participants were equally allocated to monitoring with either the WHO LCG (n = 73) or the WHO Modified Partograph (n = 73). Maternal labour parameters, mode of delivery, hospital stay, and neonatal outcomes were recorded. RESULTS:Women monitored using the WHO LCG had significantly shorter durations of the active phase and the second stage of labour and a markedly lower caesarean section rate compared with those monitored using the Modified Partograph (p < 0.001). Vaginal delivery rates were significantly higher, and hospital stays were shorter in the LCG group. Neonatal outcomes, including APGAR (appearance, pulse, grimace, activity, respiration) scores, birth weight, NICU admissions, and NICU stay duration, were comparable between the two groups. CONCLUSION:The WHO LCG is a more effective intrapartum monitoring tool than the WHO Modified Partograph, improving maternal labour outcomes without compromising neonatal safety. Its adoption may enhance labour efficiency, reduce unnecessary caesarean deliveries, and support woman-centred obstetric care.

Ashwagandha (Withania somnifera), an adaptogen, is widely used in traditional Indian medicine for its health benefits in elderly people with functional limitations and physical disabilities. This double-blind, randomized, placebo-controlled clinical trial study assessed the efficacy and safety of a standardized Ashwagandha Root Extract (ARE) on general health improvement in elderly. Fifty (32 male, 18 female) healthy people aged between 60 and 85 years who consented to participate were randomly assigned to receive either capsule ARE 300 mg twice daily orally (n = 25) or an identical placebo (n = 21) for 8 weeks. The primary efficacy outcome was change in scores for Older People's Quality of Life (OPQOL) questionnaire, whereas secondary outcomes were change in scores for the Epworth Sleepiness Scale (ESS), and Senior Fitness Test (SFT). Clinical safety was evaluated using adverse events and global assessment of tolerability to therapy (GATT) by the physician. Greater improvement in OPQOL scores was observed with ARE, compared to placebo at both week 4 (p = 0.023) and week 8 (p < 0.0001), and these differences were observed in all sub-scales of OPQOL. Patients receiving ARE showed higher improvements after week 8 for total scores for ESS (p < 0.001), and SFT sub-scales (p < 0.01). The majority of participants on ARE reported excellent to good tolerability (96.0%). No adverse events were reported in the ARE group, while one patient reported nausea and headache in the placebo group. Ashwagandha root extract can be a useful herbal intervention for the improvement of general health and quality of life in elderly men and women.

Background Ki-67 is an important proliferative biomarker in breast carcinoma; however, methodological variability in its assessment limits reproducibility and clinical applicability. The International Ki-67 in Breast Cancer Working Group (IKWG) has proposed a standardized global scoring method with a freely available Android application to address this issue. This study aimed to compare hotspot and weighted-global Ki-67 scoring methods using the IKWG Android application in invasive breast carcinoma, assess their correlation and categorization, and evaluate their diagnostic performance in predicting histological grade, with potential relevance to clinical decision-making and treatment stratification. Methodology A hospital-based, cross-sectional study was conducted on 53 cases of invasive breast carcinoma. Ki-67 immunohistochemical slides were digitally scanned and scored using both hotspot and weighted-global methods via the IKWG Android application. Statistical analysis was performed using the Mann-Whitney U test, Spearman's correlation, and receiver operating characteristic analysis. Results The hotspot method produced a markedly elevated mean Ki-67 index (57.1 ± 22.6%) in contrast to the weighted-global method (43.1 ± 24.0%; p = 0.004). Using IKWG cutoffs, 44 (83.0%) tumors were classified as high proliferative by hotspot versus 36 (67.9%) by weighted-global scoring. Both methods showed a very strong correlation (Spearman's r = 0.954, p < 0.001). The weighted-global Ki-67 demonstrated excellent diagnostic performance for predicting high-grade tumors (area under the curve = 0.991), with 100% specificity and 84.9% overall accuracy. Grade 2 tumors predominated (26 (49.1%)), followed by Grade 3 (18 (34.0%)) and Grade 1 (9 (17.0%)). Conclusions Hotspot scoring systematically overestimates tumor proliferation. The weighted-global method, incorporating intratumoral heterogeneity, provides a more balanced and biologically representative Ki-67 estimate. Standardization via the IKWG Android application improves reproducibility and supports reliable clinical decision-making.

To investigate the genetic polymorphisms associated with febrile seizures (FS) in children from Vijayapura District, Karnataka, South India. Also to identify novel or known pathogenic variants using whole exome sequencing (WES), explore clinical profiles, and assess associations with family or past history of FS. This observational study included 50 children aged 6 mo to 6 y presenting with FS at Shri B.M. Patil Medical College, Vijayapura. After excluding those with neurological deficits or atypical seizure etiologies, peripheral blood samples were collected. DNA was extracted, and exon-specific primers were designed. PCR products were subjected to Sanger sequencing, and WES was performed on 12 cases. Clinical characteristics were recorded, and statistical analysis was done using SPSS v20. Among 50 children, the most common age group was 1–2 y (50