Abstract Norovirus is one of the major causative organisms causing gastroenteritis globally, with frequent cases of co-infection involving other enteric pathogens such as rotavirus, bacteria, and parasites. These co-infections often intensify disease outcomes, leading to more severe diarrhea, dehydration, prolonged illness, and increased hospitalization compared to single infections. The interactions underlying these outcomes include immune modulation, disruption of gut microbiota, and synergistic pathogen effects, which complicate clinical management. Co-infections also pose significant challenges to vaccine effectiveness, particularly in regions where rotavirus vaccines are widely used. The overlapping presence of multiple pathogens can obscure vaccine performance and reduce perceived efficacy, especially among young children, the elderly, and immunocompromised individuals. This review highlights global and regional epidemiology, clinical outcomes, and public health implications of norovirus co-infections, with particular attention to India. It highlights the need for enhanced surveillance, integrated diarrheal disease management, and further research to guide vaccine development and policy.
Abstract Introduction: Ineffective coordination among academic and administrative units in higher education often leads to delayed decisions, fragmented planning, and weak quality assurance. To address this, the study evaluates the AUDIEX model, a structured governance intervention integrating the Internal Quality Assurance Cell (IQAC), Examination Section (controller of examinations), Academic Affairs, and University Development of Education for Health Professionals through periodic, agenda-driven coordination meetings. The study examines how this model improves institutional governance, academic planning, and quality enhancement. Methodology: A qualitative case study approach was used to assess the implementation of the AUDIEX model. Data were drawn from meeting reports and structured interviews with key stakeholders ( n = 20). Meeting records documented decisions and action outcomes, while interviews captured perceptions of effectiveness, challenges, and governance improvements. Results: Implementation of the AUDIEX model resulted in improved institutional coordination. About 92% of participants reported enhanced communication, while implementation time for joint initiatives reduced by 25%. Alignment with institutional goals was noted by 94% and 98% perceived improved accountability and transparency. Although 20% reported scheduling challenges, overall findings highlighted strengthened governance and proactive academic planning. The AUDIEX model emerges as an effective and replicable governance framework for improving coordination and quality processes in higher education institutions. Conclusion: The AUDIEX governance model shows that structured coordination enhances institutional effectiveness and decision-making. Its transferable principles – collaborative governance, shared accountability, and synchronized planning – can guide other institutions seeking governance improvement, fostering sustainable growth and continuous quality enhancement.
Abstract Brain gym exercises (BGEs) may facilitate neural plasticity, improve attention, and enhance memory by stimulating neurophysiological mechanisms. However, the existing research presents mixed findings, with some studies reporting significant benefits and others showing inconclusive results. Hence, we conducted a systematic review to investigate the effectiveness of BGE on various neuropsychological functions. The objective of this study was to review the existing body of literature on BGE and its effect on neuropsychological functions across all age groups. A digital search was conducted in PubMed, Physiotherapy Evidence Database, Cochrane Library, ScienceDirect, and Embase (Excerpta Medica Database), using predetermined keywords between October 2014 and October 2024. Studies meeting the eligibility criteria were analyzed for quality using the Joanna Briggs Institute tool, followed by descriptive synthesis. Fifteen studies were included in this review. Six were randomized controlled trials and 8 were pre- and postinterventional studies. Fifteen studies were evaluated for risk of bias. The study concludes that BGEs contribute to improvements in neuropsychological functions such as sleep efficiency, cognitive flexibility, memory, and mood regulation in individuals of all age groups.
Abstract Context: Healthcare utilization is influenced by multiple sociodemographic and socioeconomic factors. Understanding these determinants is essential to ensure equitable access and inform evidence-based health planning. Aims: To assess the sociodemographic, educational, occupational, and economic predictors of healthcare utilization among adults in rural Karnataka. Settings and Design: A community-based cross-sectional study was conducted in selected villages under the jurisdiction of two PHCs. Subjects and Methods: The study was conducted among 1400 participants selected through multistage sampling. Data on demographic, social, and economic characteristics and healthcare utilization were collected using a structured questionnaire. Statistical Analysis Used: Descriptive statistics, Chi-square tests, and logistic regression analyses were performed to identify the significant predictors. Results: The study population demonstrated a balanced gender distribution, with most participants being married (70%) and middle-aged or older adults. Education and occupation varied, with 44.57% having secondary education and 34.21% engaged in skilled work. Significant associations were found between healthcare utilization and age, gender, marital status, education, occupation, and income ( P < 0.001). Logistic regression revealed that older adults (≥61 years) had higher odds of utilization (odds ratio [OR] = 24.16, 95% confidence interval [CI]: 7.06–82.69), along with married individuals (OR = 11.09, 95% CI: 4.53–27.12) and those from nuclear families (OR = 6.21, 95% CI: 3.10–12.43). Unemployed and semi-skilled workers also showed increased odds compared to professionals. Conclusion: Healthcare utilization was significantly influenced by demographic and socioeconomic factors, particularly age, marital status, family type, and occupation. Strengthening awareness, affordability, and accessibility of healthcare services across social and occupational groups can enhance equitable utilization.
Abstract Purpose: Blindness is a global public health concern, with corneal blindness comprising approximately 4%–6% of all blindness cases in India. Eye donations are the only way to get corneal grafts from dead donors for treating corneal blindness. Cinemeducation is an educational tool which uses films to convey complex medical concepts. This study aims to assess the effectiveness and perception of cinemeducation as a teaching/learning method in ophthalmology among undergraduate medical students. Methodology: A mixed-method study was conducted among 120 Phase III Part I MBBS students of a private medical college. The intervention included showing short films on eye donation during small group discussion. A pretest and posttest questionnaire was employed to assess students’ knowledge and awareness. Quantitative data were analyzed using SPSS v20.0 with mean and standard deviation. Chi-square and independent-samples t -test were used. Qualitative feedback was obtained. The Reflections were collected via Google Form, and thematic analysis was done. Results: A total of 104 students completed the study; 34.6% were male and 65.4% of females. There was a mean increase in knowledge ( P = 0.0318) and attitude ( P = 0.0373) scores compared to the pretest. There was a significant increase in knowledge and attitude following the cinemeducation session ( P < 0.05). More than 70% of students perceived that cinemeducation was an effective learning tool. Feedback analysis showed that over 50% of medical students found the cinemeducation session engaging. Qualitative analysis of student reflections revealed positive perceptions of cinemeducation, with most students reporting enhanced critical thinking (79%), greater awareness about eye donation (74%), and its potential to promote community awareness (77%) and eye donation (73%). Conclusion: Cinemeducation proved to be an effective tool for enhancing knowledge and imparting a positive attitude about eye donation among medical students. It can be incorporated into competency-based medical education curricula to teach public health topics.
Abstract A 33-year-old nulligravida female presented with chronic mild left flank and groin pain for 6 months, with no bowel or bladder disturbances. Pelvic ultrasound and magnetic resonance imaging scan revealed a bulky uterus with a large posterior intramural fibroid measuring 12 cm × 10 cm × 10 cm and associated mild left-sided hydronephrosis. The patient underwent laparoscopic myomectomy under combined spinal and general anesthesia. Intraoperatively, the fibroid was enucleated through a transverse incision over the posterior uterine wall, and the defect was closed using Vicryl-1-0 baseball sutures. Total blood loss was minimal (approximately 100 mL), and the postoperative course was uneventful. She was discharged on the 6 th postoperative day in stable condition. Laparoscopic myomectomy can be safely and effectively performed for large posterior wall fibroids in selected patients, with good surgical outcomes and faster recovery.
Abstract Background: Osteology is a fundamental branch of anatomy studied by 1 st -year medical students, emphasising the structure, attachments, ossification, and clinical relevance of bones. Traditional teaching methods, typically conducted as tutorials with viva-based assessments, often fail to engage students, resulting in decreased interest and suboptimal performance in practical exams. This study intends to introduce a peer-assisted learning (PAL) method to enhance students’ learning outcomes, communication skills, and personal development. Materials and Methods: 100 1 st -year MBBS students were equally divided into two groups. Batch A (study group) was taught using the PAL method, while Batch B (control group) followed the traditional tutorial approach. Both groups underwent five sessions on the lower limb bones. Assessments were conducted to evaluate learning outcomes, and feedback from students was collected using a five-point Likert scale to gauge their perceptions of the PAL method and the traditional method. Results: The PAL group achieved significantly higher mean assessment scores than the traditional tutorial group (7.28 ± 2.79 vs. 3.46 ± 1.94), with a mean difference of 3.82 (independent samples t -test, P < 0.0001; 95% confidence interval: 2.87–4.77; Cohen’s d = 1.59). A majority of students reported improved preparation, enhanced understanding, greater engagement, preference for PAL, and support for its continuation. Conclusion: PAL was found to be an effective instructional strategy for osteology, significantly improving academic performance and student engagement. Integration of PAL within undergraduate anatomy teaching may support competency development and active learning in alignment with competency-based medical education principles.
Abstract Florid cemento-osseous dysplasia (FCOD) is a rare, benign, multifocal fibro-osseous jaw lesion comprising cellular fibrous connective tissue with bone and cementum-like material. Typically affecting the jawbones of middle-aged individuals, it presents as multi-quadrant radiopaque cementum-like masses. Historically known by various names, FCOD’s diagnosis and treatment were often confused. Usually asymptomatic, FCOD requires no treatment. Diagnosis is based on typical clinical and radiological features, with biopsy generally avoided due to infection risk. This report presents a rare case of bilateral mandibular FCOD in a 35-year-old woman.
Abstract Background and Aims: Pericapsular nerve group (PENG) block is a regional anesthesia technique known for its motor-sparing benefits. It is particularly useful in managing pain for patients with hip fractures, facilitating positioning for spinal anesthesia. This study compared the analgesic efficacy of different volumes of 0.25% ropivacaine (10 mL, 20 mL, and 25 mL) for patient positioning during spinal anesthesia. Materials and Methods: A total of 45 patients undergoing elective hip surgery were included in this study, with registration number CTRI/2023/06/053462 dated June 20, 2023, and were randomly divided into three groups (15 each) receiving PENG block with 10 mL, 20 mL, or 25 mL of 0.25% ropivacaine. The primary objective was to assess the Visual Analog Scale (VAS) score measured 10 min after the PENG block prior to positioning. The secondary objectives included evaluating patient acceptance of positioning, the need for rescue analgesia, and total postoperative analgesic requirements within 24 h. Results: Demographic data were comparable across groups. A statistically significant reduction in VAS scores was observed during positioning following PENG block ( P = 0.006). Patient acceptance for positioning improved with higher volumes of ropivacaine, with 100% acceptance in the 25 mL group. Rescue analgesic requirements were significantly lower in the 20 mL and 25 mL groups compared to the 10 mL group. Postoperative analgesic consumption was significantly lower in 20ml and 25ml group also. Conclusion: PENG block with 20 mL of 0.25% ropivacaine provided superior pain relief, improved patient positioning for spinal anesthesia, and reduced postoperative analgesic consumption compared to 10 mL. These findings suggest that the optimum volume for analgesia is 20 mL, with no added benefits when volume increased to 25 mL.
Abstract Objective: The study aimed to assess and evaluate the efficacy of the telematernal and neonatal assessment and care (Tele-MNAC) digital application as a diagnostic tool to enhance maternal outcomes. Design: An observational, analytical clinical study design was employed. Setting: The study was conducted at Acharya Vinoba Bhave Rural Hospital, Wardha, in the Obstetrics and Gynecology department. Population or Sample: The pregnant women who were in labor and beyond 37 weeks of gestation and had cervical dilatation exceeding 4 cm participated in the study. Those with high-risk conditions were excluded. Materials and Methods: We conducted an observational, analytical clinical study to evaluate the efficacy of the Tele-MNAC digital application as a diagnostic tool for improving maternal outcomes. The sample size was 264, equally distributed into two groups with 132 participants each. We used Tele-MNAC in the experimental group to identify maternal mortality and risk by 1 h until delivery, whereas an e-Partograph was used in the control group. Main Outcome Measures: The main outcome measures included maternal outcomes. Results: The analysis includes 266 patients admitted to labor and delivery, with 134 in the Treatment group and 132 in the Control Group. Baseline characteristics were similar between both the groups at recruitment. Tele-MNAC significantly reduced maternal complications by 50%, reduced maternal deaths by 32%, and decreased the transfer of patients to the intensive care unit by 32% compared to the respective risk in the control group. Conclusion: The Tele-MNAC digital application proves effective in early detection of physiological changes in pregnant mothers, offering the potential as a diagnostic tool to enhance maternal outcomes and reduce complications.
Abstract Uterine leiomyosarcoma (LMS) is rare in women of reproductive age, often mimicking benign fibroids. We report a 28-year-old multiparous woman who presented with abnormal uterine bleeding and was diagnosed with a presumed uterine fibroid on imaging (ultrasound and magnetic resonance imaging). She underwent abdominal myomectomy, but postoperative histopathology unexpectedly revealed LMS, confirmed by immunohistochemistry (smooth muscle actin positivity and Ki-67 index ~10%). The patient then underwent a complete total abdominal hysterectomy without complications. This case highlights the diagnostic challenge of uterine LMS in young women and underscores the importance of routine histopathological examination of excised uterine masses. Early recognition of LMS is crucial for appropriate management and improved patient outcomes.
Abstract Background: The spleen is located in left hypochondrium and epigastrium, underneath the left half of the diaphragm, along the 9 th , 10 th , and 11 th ribs. Its shape shows variations, from a curved wedge to a domed tetrahedron. The spleen consists of two poles, two surfaces, two angles, three borders, and a hilum. The superior border can have one or more notches. Aim: The study aimed to study the dimensions (breadth, length, and thickness) and weight, along with the congenital anomalies seen in a human spleen. Materials and Methods: Fifty adult human spleens were procured from the embalmed cadavers of both sexes, from the Department of Anatomy, KAHER’s J.N. Medical College, Belagavi. The dimensions (length, breadth, and thickness) were measured using Vernier calipers and the weight was also noted. Congenital anomalies were also detected. Results: This present study included 50 human cadaveric spleens. The types of splenic shapes ranged from wedge-shaped (48%) to tetrahedral (18%), semilunar (6%), dome (2%), oval (10%), triangular (10%), and irregular (6%). The weight of the spleen varied from 23.9 to 391.7 g in nearly all of the specimens. Variations in breadth, length, and thickness were also observed and noted. Congenital abnormalities such as bilobed spleen (2%) and central notch (2%) were seen. Conclusion: Knowledge of splenic morphology and its variations can aid anatomists in their routine cadaveric dissections. The findings of this present study can help imaging specialists to avoid interpretational errors and can further assist in the diagnosis. They may also aid surgeons in planning appropriate surgical methods.
Abstract We report a rare case of fingerprint loss (acquired adermatoglyphia) in a 40-year-old woman with a long-standing history of obsessive–compulsive disorder, characterized by compulsive handwashing. This case highlights a rare dermatological consequence of repetitive compulsive behavior and underscores the importance of timely psychiatric and dermatologic intervention to prevent permanent damage.
Midlife is acknowledged as a critical window of opportunity for empowering women, as this period marks the transition into menopause, which is characterized by multiple hormonal changes that impact physical and mental health. The purpose of the current article is to explore the prospects of midlife phase among women as a window of opportunity for facilitating healthy ageing, identify existing barriers, propose targeted solutions to overcome these identified barriers, and elaborate the role of public healthcare delivery system in improving the existing scenario. An extensive search of all the materials related to the topic was carried out in the PubMed search engine for the published literature during 2015–2025. Initially, 39 research articles were identified based on the keyword’s midlife, women, aging, and menopause in the title alone and were screened for eligibility. Overall, 27 articles were selected based on the suitability with the current review objectives and analyzed. Acknowledging the scope and the impact that targeted interventions can have on midlife women in improving their health and well-being, it is indeed a reality that we have not been successful in capitalizing on these available opportunities. This has been because of the presence of multiple barriers, like many healthcare systems are not customized to address the specific health needs of midlife women, especially in low- and middle-income nations. To improve the health and well-being of midlife women and to facilitate healthy aging, the public health system plays a pivotal role in addressing their unique needs. In conclusion, midlife women are prone to experience multiple health and social pressures, which could be detrimental to healthy aging. The need of the hour is to optimally utilize this phase in the life of women by effectively addressing the potential barriers that could jeopardize the well-being and quality of life of women.
Chordoma is a rare, slow-growing malignant tumor of notochordal origin, accounting for 1%-4% of primary skeletal neoplasms, most commonly in the sacrococcygeal region. We report a 44-year-old male with dull, progressive sacrococcygeal pain and numbness for 6 months. Imaging showed a lytic, metabolically active sacral-coccygeal lesion, and surgical excision yielded a 6 cm & times; 5 cm & times; 3.5 cm gelatinous mass. Histology revealed physaliferous cells in a lobulated, myxoid background, confirming conventional chordoma, with brachyury positivity. The tumor involved the posterior margin. Given their aggressive, recurrent nature, chordomas require complete excision, radiotherapy, and multidisciplinary evaluation for optimal outcomes.
