West Bengal University of Health Sciences

ABSTRACT Background Cervical cancer is a major cause of death among Indian women, even though the HPV vaccine and routine screening can prevent it. Himachal Pradesh launched a state-funded HPV vaccination drive in early 2026. This study looks at what adolescent schoolgirls know about cervical cancer, whether they understand the vaccine, and what influences their choices. Methods We surveyed 516 female students across seven schools (five government and two private) in Bilaspur and Shimla districts of Himachal Pradesh between May and July 2026 (93.8% response rate). The survey covered knowledge of cervical cancer, HPV, vaccine benefits, vaccination status, fears about infertility, and willingness to get vaccinated if advised by a doctor. Results While 71.9% (371/516) of girls had heard of cervical cancer, only 47.3% (244/516) knew it begins in the cervix or lower uterus, 76.0% (392/516) knew no symptoms, and only 27.5% (142/516) recognized that it can be prevented ( p < 0.001). Similarly, 61.6% (318/516) had heard of the HPV vaccine, but only 41.9% (216/516) had heard of HPV itself ( p < 0.001), and only 50.0% (258/516) knew the vaccine prevents infection. Only 12.8% (66/516) had received at least one dose, and just two girls (0.4%) had finished all required doses. When asked if they would get vaccinated on a doctor’s advice, 45.3% (234/516) wanted more information first, 34.1% (176/516) refused, and 20.5% (106/516) agreed. Three out of four girls (75.6%, 390/516) were concerned or uncertain about whether the vaccine causes infertility. Only 3.5% (18/516) had heard of a Pap smear. Conclusion The findings demonstrate a pronounced decoupling between nominal awareness and actionable prevention literacy among adolescent schoolgirls in Himachal Pradesh. The predominant driver of vaccine hesitation was an unmet informational requirement rather than active ideological refusal. School-based immunization campaigns must incorporate structured, age-appropriate educational curriculum addressing the need of vaccination and infertility misconceptions prior to injection sessions.

Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity. Recognising the need for region-specific guidance, the Skin Allergy Research Society and Society for Eczema Studies have collaborated to develop updated, evidence-based guidelines tailored to the Indian context. These guidelines address AD management across all age groups, special populations while considering local epidemiology, healthcare infrastructure, and treatment accessibility. A structured Delphi consensus process was conducted among 23 dermatology experts over 3 months through virtual and in-person meetings. Literature from MEDLINE, Cochrane, and Google Scholar was systematically reviewed, and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach was used to assess evidence quality. Clinical recommendations were refined through multiple voting rounds, leading to consensus statements. Recommendations are based on an extensive literature review up to December 2024. This document updates the 2019 Skin Allergy Society guidelines, reinforcing global recommendations while allowing local adaptability. These guidelines provide updated recommendations for topical, systemic, phototherapy, and biologic therapies in AD. Key advancements include the introduction of topical crisaborole and JAK inhibitors for mild to moderate AD, along with a focus on emerging systemic therapies, such as biologics and systemic JAK inhibitors. In the Indian context, the guidelines define the roles of dupilumab and abrocitinib while also addressing the off-label use of tofacitinib and baricitinib in resource-limited settings. Specific recommendations are provided for children, elderly patients, and pregnant women, emphasising safety considerations for systemic and biologic therapies. These guidelines align with global AD management while incorporating India-specific adaptations based on epidemiology, accessibility, and affordability. They serve as a key reference for dermatologists, pediatricians, and general practitioners in India and other resource-limited settings. Though tailored for India, they are also relevant to dermatologists in developing countries, guiding treatment selection based on disease patterns, environmental factors, and medication availability.

Abstract Background: Many adults with type 2 diabetes mellitus (T2DM) in India have a thin fat body type, with low skeletal muscle mass for their body mass index. Muscle is the main site of glucose disposal after a meal. Fasting blood sugar (FBS) mostly reflects glucose output from the liver, whereas postprandial blood sugar (PPBS) depends more on insulin driven glucose uptake by muscle. Objective: To show how the association between sarcopenia risk and postprandial glycemic excursion would be tested in older adults with T2DM and controlled fasting glucose. Methods: A cross sectional design is planned for adults aged 50 years or more with T2DM, FBS between 90 and 130 mg/dL and a stable oral regimen. Sarcopenia risk is measured with the SARC F questionnaire. Glycemic excursion (BG) is PPBS minus FBS. The method was applied to a dataset of 300 patients collected over an OPD setting. Groups were compared with Welchs t test, the relationship between SARC F score BG was tested with Pearsons correlation, and multiple linear regression adjusted for age, diabetes duration, FBS and drug regimen. Results: In the patient dataset (mean age 67.6 +/ 6.8 years), 64 patients (21.3%) had a high risk SARC F score. BG was 119.4 +/ 29.1 mg/dL in the high risk group and 74.8 +/ 22.8 mg/dL in the low risk group (difference 44.6 mg/dL, 95% CI 36.8 to 52.5; p<0.0001). SARC F score and BG were positively correlated (r = 0.777, p<0.0001). After adjustment, each 1 point rise in SARC F score was linked to a 10.2 mg/dL higher BG (95% CI 8.6 to11.7). The high risk group was about 6 years older, and age and diabetes duration explained part of the crude difference. Conclusion: The analysis plan can detect and quantify a link between SARC F score and post meal glucose rise while accounting for age, diabetes duration, FBS and drug regimen. Clinical treatment algorithms must shift from exclusively targeting insulin secretion to restoring the mechanical glucose sink through resistance training and age appropriate pharmacological adjustments ### Competing Interest Statement The authors have declared no competing interest. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of R.G.Kar Medical College Kolkata gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors

Background: Schizophrenia is a chronic neuropsychiatric disorder in which oxidative stress has been implicated as a key pathogenic mechanism. Imbalance between free radical generation and antioxidant defense may contribute to neuronal damage. This study aimed to evaluate oxidative stress and antioxidant status in schizophrenia by estimating serum malondialdehyde (MDA) and plasma superoxide dismutase (SOD) respectively, and to examine their interrelationship. Methods: This analytical case–control study included 50 participants aged 18–40 years, comprising 25 patients with schizophrenia (diagnosed according to ICD-10 criteria) and 25 age- and sex-matched healthy controls. Serum MDA levels were estimated using the thiobarbituric acid reactive substances method, while plasma SOD activity was measured spectrophotometrically using the PMS–NBT method. Data were analyzed using independent samples Student’s t-test and Pearson’s correlation. A p-value <0.05 was considered statistically significant. Results: Mean serum MDA levels were significantly higher in cases compared to controls (5.61 ± 0.36 vs 2.84 ± 0.61 nmol/mL; p < 0.001). Plasma SOD activity did not differ significantly between cases and controls (9.40 ± 1.62 vs 9.04 ± 1.87 U/mL; p = 0.470). Pearson’s correlation analysis revealed no significant association between MDA and SOD in cases (r = 0.058, p = 0.784), whereas a moderate positive correlation was observed in controls (r = 0.597, p = 0.002). Conclusion: The findings indicate increased lipid peroxidation in schizophrenia, reflecting enhanced oxidative stress, without a proportional antioxidant response. The absence of correlation between MDA and SOD in patients suggests disrupted oxidative–antioxidant balance. These results support the role of oxidative stress in the pathophysiology of schizophrenia and highlight the potential relevance of redox biomarkers in future research. Keywords: Schizophrenia; Oxidative Stress; Malondialdehyde; Superoxide Dismutase; Lipid Peroxidation; Antioxidants

Small-bowel adenocarcinoma is frequently interpreted using pathological principles established for colorectal carcinoma, despite differences in anatomical origin, precursor morphology, inflammatory background and invasive histotypes. This critical narrative review examines the diagnostic consequences of gastric-type duodenal neoplasia, Crohn-associated nonconventional dysplasia, coeliac-associated carcinoma, medullary morphology and colorectal-like immunophenotypes. Published pathological cohorts demonstrate molecular concordance between selected nonconventional dysplastic precursors and Crohn-associated carcinomas, frequent mismatch-repair deficiency in medullary carcinomas, and SATB2 expression in a proportion of primary small-bowel adenocarcinomas. Although tumour budding and lymph-node ratio show prognostic associations, their broader application requires independent validation. An assessment integrating anatomical epicentre, background mucosa, precursor phenotype, invasive architecture and appropriately selected immunohistochemistry strengthens diagnostic interpretation without requiring a new classification or prognostic model. Colorectal pathology remains an important comparator but cannot substitute for independent pathological evaluation of small-bowel adenocarcinoma.