Background: Objective: To determine the prevalence of, and factors associated with, controlled drug misuse among health workers at two health facilities within Ibanda District. Methods: A hospital-based cross-sectional study was conducted among health workers at two health facilities in Ibanda District. A census sampling approach was employed, in which all 144 eligible health workers were invited to participate; 115 consented, yielding a response rate of 79.9%. Data were collected using a structured, self-administered questionnaire and analyzed in SPSS version 27.0. Descriptive statistics were used to summarize the characteristics of the respondents and the prevalence of misuse. Chi-square tests examined bivariate associations, and variables with p<0.20 were entered into a binary logistic regression model with multiple explanatory variables. Statistical significance was set at p<0.05. Results: The prevalence of controlled drug misuse was 46.96% (54/115). Among those reporting misuse, pain management (59.26%), sleep aid (29.63%), and stress relief (11.11%) were the most cited reasons, while tramadol (42.6%) and opioids (40.7%) were the most commonly misused substances. At the bivariate level, years of work experience, weak supervision, infrequent stocktaking, easy access to controlled drugs, excessive workload, inadequate staffing, extra shifts, pressure to maintain a professional image, anxiety, use of sedatives or alcohol to aid sleep, and emotional exhaustion were significantly associated with misuse (p<0.05). After adjustment for confounders, emotional exhaustion remained the sole independent predictor of controlled drug misuse (AOR=15.40; 95% CI: 1.75-135.53; p=0.014). Conclusion: Controlled drug misuse is widely reported among health workers involved in the study facilities. Emotional exhaustion emerged as the strongest independent correlate, drawing attention to the effects of workplace pressure, stress, and burnout in contributing to misuse behaviours. Recommendation There should be strengthening of controlled drug management systems and instituting staff mental health and wellness programs to help reduce controlled drug misuse among healthcare workers.
Background Gestational diabetes mellitus (GDM) is a significant public health problem associated with adverse maternal and fetal outcomes. This study aims to determine the prevalence and associated risk factors of gestational diabetes mellitus among pregnant women attending the antenatal clinic at Mengo Hospital in Kampala District. Methods A hospital-based cross-sectional study was conducted among 100 pregnant women attending antenatal care at Mengo Hospital. Participants were selected using simple random sampling. Data were collected using structured questionnaires and laboratory testing using the Oral Glucose Tolerance Test (OGTT) based on WHO 2013 diagnostic criteria. Data were analyzed using SPSS version 20 and presented using tables, charts, bar graphs, and descriptive statistics. Result The prevalence of gestational diabetes mellitus among the study participants was 12%. A higher proportion of GDM cases occurred among women aged 35 years and above (45%). Obesity (BMI ≥30 kg/m²) accounted for 15.6% of all GDM cases. Other important factors included family history of diabetes (58.3%), multiparity (50%), previous macrosomia (41.7%), previous history of GDM (33.3%), and hypertension (41.7%). Most GDM cases were observed among married women and those with tertiary education. Conclusion The prevalence of GDM at Mengo Hospital is notably high. Both modifiable and non-modifiable risk factors significantly contribute to its occurrence, highlighting the need for routine screening and targeted interventions during antenatal care. Recommendations Routine universal screening for GDM should be strengthened during ANC visits, with emphasis on high-risk groups such as older mothers, obese women, and those with a positive family history of diabetes.
Background Spondylolisthesis may cause chronic low back pain, radiculopathy, neurological deficits, and functional disability. Surgical treatment is indicated in patients with persistent symptoms despite conservative management or progressive neurological impairment. Pedicular screw-rod fixation with posterolateral fusion provides spinal stabilization and promotes fusion. Objectives: To evaluate the clinical, functional, radiological, and neurological outcomes of patients with spondylolisthesis treated with pedicular screw-rod fixation and posterolateral fusion. Materials and methods A retrospective observational study was conducted at Katihar Medical College, Bihar, India. Medical records of 30 patients who underwent surgical management for spondylolisthesis between November 2023 and November 2025 were reviewed. Demographic, clinical, radiological, operative, and postoperative data were collected. Functional outcomes were assessed using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. Radiological fusion and postoperative complications were also evaluated. Statistical analysis was performed using IBM SPSS Statistics version 26.0. Results The mean age was 46.8 ± 11.2 years, with females comprising 60.0% of patients. Degenerative spondylolisthesis was predominant (63.3%), and L4–L5 was the most commonly affected level (56.7%). Mean VAS scores improved from 7.8 ± 1.1 preoperatively to 2.1 ± 0.9 at final follow-up (p<0.001), while ODI scores improved from 58.6 ± 10.5 to 18.4 ± 7.3 (p<0.001). Radiological fusion was achieved in 93.3% of patients, and 86.7% achieved excellent or good outcomes according to modified MacNab criteria. No implant failure or revision surgery occurred. Conclusion Pedicular screw-rod fixation with posterolateral fusion resulted in significant pain relief, functional improvement, and high fusion rates with few postoperative complications. Recommendation This procedure may be considered an effective surgical option for appropriately selected patients with symptomatic lumbar spondylolisthesis. Larger multicenter studies with longer follow-up are recommended.
PurposeTo report a case of bilateral papilloedema secondary to cerebral venous sinus thrombosis (CVST) in association with vitamin B12 deficiency, emphasizing the importance of early recognition and management to achieve resolution of papilloedema with full visual recovery. ObservationsA 44-year-old female presented with a 1-month history of headache and blurred vision. Ophthalmological evaluation revealed visual acuity of 6/6 in the right eye and 6/9 in the left eye, normal intraocular pressure (IOP), and bilateral Grade 3 papilloedema on fundus examination. Magnetic Resonance Venography (MRV) identified thrombosis of the left transverse and sigmoid sinuses, confirming CVST. Laboratory investigations revealed low serum vitamin B12 levels. The patient was started on anticoagulation therapy and vitamin B12 supplementation. Over the following 8 weeks, her symptoms improved significantly, and fundus examination showed complete resolution of papilloedema with recovery of visual function ConclusionThis case shows that a timely medical intervention can produce favourable visual outcomes in cases of papilloedema and highlights it to be a reversible entity with optimum visual recovery. ImportancePrompt diagnosis and targeted therapy in patients with papilloedema due to CVST can lead to full visual recovery, underscoring the reversible nature of this condition when managed early.
Background: Enteric fever continues to pose a significant public health challenge in Bihar, attributed to inadequate sanitation, restricted diagnostic capabilities, and the escalating risk of antibiotic resistance (AMR). Traditional diagnostic techniques, including blood culture and serological assays, have limitations in sensitivity and specificity, hence requiring enhanced diagnostic methodologies. Objective: To assess the clinico-immunological characteristics and antibiogram of Salmonella species responsible for enteric fever in a tertiary care facility in Bihar. Methods: This hospital-based cross-sectional observational study was performed at IGIMS, Patna, over a duration of 12 months. A total of 163 individuals, aged 12 years and older, with clinically suspected enteric fever were included. Blood specimens were obtained for culture and antibiotic susceptibility analysis. Immunological assays, specifically Widal and Typhidot, were conducted. Statistical analysis was conducted with Epi Info, with a p-value of less than 0.05 being significant. Results: Blood culture positivity was noted in 30.7% of instances. The Widal and Typhidot tests showed high positivity rates but low specificity. A notable correlation was identified between Widal test outcomes and blood culture results (p < 0.05). Multidrug-resistant (MDR) Salmonella strains were discovered, demonstrating a substantial association between culture-positive and resistance patterns (p < 0.05). Conclusion: Enteric fever is a major contributor to acute illness in Bihar. The restricted specificity of serological assays and the rise of multidrug-resistant bacteria underscore the necessity for shifting serology to automated identification and AST systems. Enhancing surveillance, advocating for judicious antibiotic utilisation, and using automated diagnostics are crucial for improving patient outcomes and managing antimicrobial resistance. Recommendation: Blood culture should be the principal diagnostic method, supplemented by serological testing. The implementation of rapid automated diagnostics and regular antibiogram testing is crucial. Prudent antibiotic utilisation, enhanced surveillance, and superior cleanliness are essential for managing enteric fever and addressing escalating antimicrobial resistance.
Background: The football pools are still around today and are, in fact, the source of inspiration for fixed odds on gambling. To assess the influence of at-risk gambling on the mental well-being of the youth in Nakawa Division, Kampala District, Uganda. Methodology: The study employed a cross-sectional survey research design. Quantitative data were analysed using a computerised data analysis program known as the Statistical Package for Social Sciences (SPSS) version 25. Results: There was a significant but negative effect of at-risk gambling on mental well-being (β=.211, p=.007). Specifically, the study results show that at-risk gambling significantly accounted for 4.4% of the variance in mental well-being (R2 =0.044, F (1,369), p =.000). Furthermore, the regression coefficient for at-risk gambling was found to be -0.392 with a standard error of 0.095. This implies that for every unit increase in at-risk gambling behaviour, mental well-being decreases by 0.392 units. The negative relationship between at-risk gambling and mental well-being was found to be statistically significant (t(369)=-4.140, p=0.000). This affirms the predictive power of at-risk gambling behaviour on mental well-being. However, since the R2 is below 0.25, this indicates that the effect size is small. Thus, the R2 of 0.044 obtained in the present regression model indicates that at-risk gambling behaviour plays a moderate but significant role in mental well-being. The majority of the respondents were self-employed (51.9%). Conclusion: At-risk gambling was found to have a significant negative effect on youth mental well-being, particularly influencing social and environmental well-being. Youth engaged in at-risk gambling reported strained relationships, financial instability, and exposure to gambling environments that heightened psychological stress. Recommendations: It is recommended that the Ministry of Finance, together with the Ministry of Gender, Labour and Social Development, develop and fund youth empowerment programs that provide vocational skills and employment opportunities.
Background: Rheumatoid Arthritis (RA) is a chronic autoimmune inflammatory disorder affecting 0.3-1.0% of the global population, managed through conventional, complementary, and alternative treatment strategies. Awareness and acceptance of Complementary and Alternative Medicine (CAM) among the general population remain poorly understood, particularly in relation to educational background and personal exposure to RA. This study aimed to assess CAM awareness and identify factors influencing hypothetical treatment selection for RA. Methods: A cross-sectional, mixed-methods study was conducted among 200 randomly selected participants using an online, bilingual (English/Hindi) structured questionnaire. Participants were presented with a hypothetical RA scenario and asked to select preferred treatment options among conventional, complementary, and alternative therapies. The influence of educational qualification and prior acquaintance with an RA patient on treatment selection was analyzed using Fisher's exact test. Results: Of 200 participants, 110 (55.0%) were male, and 90 (45.0%) were female; 136 (68.0%) were aged 18–30 years. Overall, 55.3% were unaware of the term CAM. Diet, physiotherapy, meditation, and yoga were among the most preferred treatment options. Educational qualification significantly influenced meditation/yoga selection (p = 0.0139), while prior acquaintance with an RA patient significantly increased selection of diet/physiotherapy (p = 0.0006) and meditation/yoga (p = 0.0026). Conclusion: Personal exposure to RA, rather than education alone, was a stronger predictor of preference for complementary, lifestyle-based therapies, underscoring the need for greater public awareness of CAM in RA management. Recommendation: The study recommends improving public awareness of CAM and its evidence-based role in RA management, particularly regarding appropriate complementary and lifestyle-based therapies.
Background: The study aimed to determine the quantities of total serum IgG antibodies against CSP among Postpartum Mothers attending Kawempe National Referral Hospital. Methodology: A cross-sectional nested study was conducted using 194 archived serum samples randomly selected from 400 postpartum women who participated in a parent study at Kawempe National Referral Hospital. Samples stored at −80°C were analyzed at Makerere University College of Health Sciences Medical Biochemistry Laboratory. Anti-CSP IgG levels were quantified using ELISA, while IgG affinity was assessed using an ammonium thiocyanate avidity assay. Data were analyzed in Stata 14.2 using descriptive and inferential statistics, with statistical significance set at p≤0.05. Results: Among 194 postpartum mothers, 100.00% attended ANC; married/cohabiting mothers comprised 90.72%, while 9.28% were single/separated. With 51.03% having <4 visits and 48.97% having ≥4 visits. Fansidar was received by 64.25%, while 35.75% did not receive it. HIV status was negative in 97.94%, positive in 0.52%, and unknown in 1.55%. Mosquito-net ownership was reported by 96.37%, while 3.63% did not own a net. Overall median serum IgG antibody titre was 0.09875 OD (IQR: 0.044–0.370). Median titres were 0.0840 OD (IQR: 0.0415–0.3875) among mothers with <4 ANC visits and 0.1050 OD (IQR: 0.04735–0.3545) among those with ≥4 visits (p = 0.9297). Fansidar recipients had a median titre of 0.1160 OD (IQR: 0.049175–0.3725) versus 0.0670 OD (IQR: 0.0345–0.370) among non-recipients (p = 0.2191). Net owners had 0.09875 OD (IQR: 0.04465–0.370) versus 0.1325 OD (IQR: 0.026–0.765) among non-owners (p = 0.7643). Conclusion: IgG antibody levels were modest, reflecting low recent malaria exposure likely due to effective malaria control interventions. Recommendation: The Ministry of Health should strengthen malaria surveillance and research to monitor serum IgG levels against CSP among postpartum mothers.
Background: To compare postoperative quality of recovery and perioperative outcomes between opioid-free total intravenous anaesthesia (OFTIVA) and conventional opioid-based total intravenous anaesthesia (OTIVA) in women undergoing ambulatory gynecologic laparoscopy. Materials and Methods: This retrospective comparative study included 120 women who underwent elective ambulatory gynecologic laparoscopy under total intravenous anaesthesia at Gouri Devi Institute of Medical Sciences and Hospital, West Bengal, India, from March 2025 to April 2026. Patients were categorized into OFTIVA (n=60) and OTIVA (n=60) groups according to the anaesthetic technique documented in hospital records. The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 hours. Secondary outcomes included postoperative pain, postoperative nausea and vomiting (PONV), rescue analgesic requirement, time to ambulation, post-anaesthesia care unit (PACU) stay, haemodynamic variables, and patient satisfaction. Results: The OFTIVA group had significantly higher QoR-15 scores than the OTIVA group (130.6 ± 7.8 vs 119.4 ± 9.3; p<0.001). VAS pain scores were significantly lower with OFTIVA at 2, 6, 12, and 24 hours (all p<0.001). PONV occurred in 10.0% versus 31.7% of patients (p=0.003), while rescue analgesia was required in 26.7% versus 65.0% (p<0.001). OFTIVA was associated with earlier ambulation (5.9 ± 1.5 vs 7.8 ± 2.0 hours; p<0.001) and shorter PACU stay (76.5 ± 15.3 vs 98.7 ± 19.6 minutes; p<0.001). Patient satisfaction was also significantly higher with OFTIVA (p=0.002). Mean heart rate was lower with OFTIVA (73.8 ± 7.5 vs 79.4 ± 8.6 beats/min; p<0.001), while hypotension and bradycardia did not differ significantly. Conclusion: OFTIVA was associated with improved postoperative recovery and comparable haemodynamic outcomes compared with OTIVA in women undergoing ambulatory gynecologic laparoscopy. Recommendation:OFTIVA may be considered for appropriately selected patients undergoing gynecologic laparoscopy. Prospective multicentre studies are recommended to confirm these findings.
Introduction Smoking among young people is a major public health problem. In Mukulua, social environment, peer influence, pleasure, taste, and stress contribute to tobacco use. This study aimed to identify sociodemographic, social, and behavioral factors associated with smoking and to propose appropriate health education, including prevention and smoking cessation. Methods A descriptive cross-sectional analytical study was conducted from May 23 to June 25, 2026, in the Mukulua Health Area among 384 young people aged 15–30 years. Convenience sampling was used. Data were collected through a questionnaire following a pre-survey and informed consent, while maintaining confidentiality. Results The study found that 83.6% of young people had smoked previously, with males predominating. The social environment was the main source of information (96%). The main reasons for smoking were peer influence (33.3%), pleasure and taste (29.3%), and stress (22.1%). Age, occupation, and marital status were significantly associated with smoking. Discussion Smoking among young people in Mukulua was mainly associated with peer influence, pleasure, taste, and stress. Age, occupation, and marital status also showed significant associations. Despite good knowledge of the health risks, smoking prevalence remained high and cessation was difficult. Conclusion Smoking among young people in Mukulua is multifactorial, mainly associated with peer influence, pleasure, stress, and certain sociodemographic characteristics. Despite awareness of the risks, tobacco use remains high and quitting is difficult. Integrated, participatory, and youth-friendly health education is therefore needed.
Background Nasal carriage of Staphylococcus aureus among health care workers is an important reservoir for hospital transmission, particularly when methicillin-resistant strains are present. Screening of anterior nares helps identify silent carriers and supports targeted infection-control measures. Objectives To estimate the prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus among health care workers in a tertiary care hospital and to describe the antimicrobial susceptibility profile of MRSA isolates, including inducible clindamycin resistance. Methods This hospital-based prospective cross-sectional study was conducted in the Department of Microbiology, S.P.V. Government Medical College, Machilipatnam, Andhra Pradesh, India, from July to September 2025. Using consecutive sampling, 230 health care workers involved in direct or indirect patient-care services were enrolled. Anterior nasal swabs were collected and processed by conventional culture methods; Staphylococcus aureus isolates were tested phenotypically for methicillin resistance, and MRSA isolates were evaluated for inducible clindamycin resistance. Results The 230 participants represented multiple occupational groups: laboratory technicians/assistants 71 (30.9%), staff nurses 68 (29.6%), doctors 61 (26.5%), MNO/FNO personnel 20 (8.7%), and other clinical/support staff 10 (4.3%). Coagulase-negative Staphylococcus was isolated from 204 (88.7%) samples. Staphylococcus aureus was isolated from 17 participants (7.4%); five isolates were methicillin resistant, giving an MRSA carriage prevalence of 2.2% among all health care workers and 29.4% among Staphylococcus aureus carriers. One MRSA isolate showed inducible clindamycin resistance. Conclusion The study demonstrated a low overall MRSA nasal carriage rate among health care workers, but nearly one-third of Staphylococcus aureus carriers harboured methicillin-resistant strains. Periodic screening remains useful for strengthening hospital infection-prevention practices. Recommendations Hospitals should conduct periodic MRSA surveillance among high-contact staff, reinforce hand hygiene, and ensure laboratory reporting of inducible clindamycin resistance before clinical use of clindamycin.
Background Dog bite injuries remain an important public health problem because of wound-related morbidity, demand for emergency care, and the risk of rabies after exposure. Hospital-based data help quantify service burden and guide post-exposure prophylaxis planning. Objective To assess the burden, epidemiological profile, and documented wound management practices of dog bite injuries at Government General Hospital, Machilipatnam. Methods This retrospective, record-based cross-sectional observational study reviewed all eligible dog bite injury records reported from January to December 2025. A total-enumeration approach was used, with all documented eligible cases during the study period included. Data were compiled for demographic categories and documented management practices. Descriptive statistics were used, and results were expressed as frequencies and percentages. Results A total of 3776 dog bite injury cases were reported during the one-year study period. Adult males constituted the largest group with 1905 cases (50.5%), followed by adult females with 1114 cases (29.5%). Male children accounted for 515 cases (13.6%), and female children accounted for 242 cases (6.4%). Overall, males, including adult males and male children, represented 2420 cases (64.1%), while females represented 1356 cases (35.9%). Adults formed 3019 cases (80.0%), and children formed 757 cases (20.0%). Documented management practices included wound washing, rabies vaccination, and rabies antiserum administration where clinically indicated. Conclusion Dog bite injuries contributed a substantial clinical burden at Government General Hospital, Machilipatnam. Adult males were the most frequently affected group, while children formed one-fifth of the caseload. Strengthening wound care documentation, vaccine completion tracking, rabies antiserum availability, and public awareness can improve post-exposure care quality. Recommendations Strengthen wound care documentation, ensure vaccine completion, maintain rabies antiserum availability, improve surveillance, and expand awareness on dog bite prevention.
Background: Hypertensive disorders of pregnancy are important contributors to maternal morbidity and adverse obstetric outcomes. Early recognition of clinical severity and organ dysfunction is essential for timely management. Objectives: To describe the clinical profile of hypertensive disorders of pregnancy and evaluate their association with maternal complications among pregnant women attending a tertiary care hospital. Methods: This hospital-based cross-sectional observational study was conducted at Government Medical College/Government General Hospital, Nizamabad, Telangana, India, from April 2025 to September 2025. A total of 100 pregnant women diagnosed with hypertensive disorders of pregnancy were included. Baseline obstetric details, clinical symptoms, blood pressure severity, proteinuria, platelet count, liver enzymes, serum creatinine, and maternal complications were recorded. Associations with maternal complications were assessed using the chi-square test. Results: The mean age was 26.8 ± 4.7 years, and 54.0% were multigravidae. Gestational hypertension was observed in 38.0%, preeclampsia without severe features in 22.0%, preeclampsia with severe features in 26.0%, eclampsia in 8.0%, and chronic hypertension with superimposed preeclampsia in 6.0%. Maternal complications occurred in 33.0% of women. Postpartum hemorrhage was the most common complication, followed by placental abruption and HELLP syndrome. Severe hypertensive disorders were significantly associated with maternal complications. Severe-range blood pressure, proteinuria, thrombocytopenia, elevated liver enzymes, and raised serum creatinine were significantly associated with adverse maternal outcomes. Conclusion: Severe forms of hypertensive disorders of pregnancy were associated with a higher burden of maternal complications. Clinical severity and biochemical derangements were useful indicators of maternal risk. Recommendations: Structured antenatal screening, early referral, and close monitoring of severe features are recommended to reduce maternal morbidity.
Background Congenital pulmonary airway malformation is a rare congenital lung anomaly for which the optimal timing of surgical resection remains controversial. This study evaluated the association between surgical timing and postoperative outcomes. Objective To assess the influence of early versus delayed surgical resection on postoperative outcomes and prognosis in children with congenital pulmonary airway malformation Methods This retrospective observational study included 24 children who underwent surgical resection at the Department of Pediatric Surgery, Indira Gandhi Institute of Medical Sciences, Patna, from January 2023 to December 2024. Patients were categorized into early surgery (≤6 months; n=11) and delayed surgery (>6 months; n=13). Demographic, clinical, radiological, operative, postoperative, histopathological, and follow-up data were analyzed. Continuous and categorical variables were compared using appropriate statistical tests, with p<0.05 considered significant. Results The median age at surgery was 8 months (IQR: 4–18), and 14 (58.3%) patients were male. Antenatal diagnosis was established in 15 (62.5%) patients. Thoracoscopic lobectomy was completed in 16 (66.7%). Early surgery was associated with shorter hospital stay (5.1±1.0 vs. 7.2±1.4 days; p=0.003) and shorter chest tube duration (2.7±0.8 vs. 3.8±1.1 days; p=0.014). Postoperative complications occurred in 1 (9.1%) early-surgery patient and 4 (30.8%) delayed-surgery patients. Delayed surgery was significantly associated with postoperative complications (OR 5.21, 95% CI: 1.10–24.62; p=0.038). No mortality or recurrence was observed. Conclusion Early surgical resection was associated with more favorable postoperative recovery and excellent short-term prognosis. Recommendations Early referral and elective surgical management during infancy should be considered when clinically appropriate. Larger multicentre prospective studies with longer follow-up are recommended to establish the optimal timing of surgery.
Background: Type 2 diabetes mellitus requires individualized antidiabetic therapy because glycaemic status, dyslipidaemia, and renal dysfunction commonly coexist and influence treatment selection. Biochemical monitoring helps clinicians identify patients with poor metabolic control and early renal risk. Objectives: To assess the association between antidiabetic drug therapy and biochemical markers of glycaemic control, lipid profile, and renal function among patients with type 2 diabetes mellitus. Methods: This cross-sectional observational study included 100 patients with type 2 diabetes mellitus attending Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India, from February 2025 to January 2026. Demographic details, duration of diabetes, body mass index, comorbidities, antidiabetic therapy, fasting blood glucose, postprandial blood glucose, HbA1c, lipid parameters, serum urea, serum creatinine, estimated glomerular filtration rate, and urine albumin-creatinine ratio were recorded. Associations were analysed across therapy groups. Results: The mean age was 53.2 ± 10.6 years, and males constituted 56.0%. Metformin monotherapy was used in 26.0%, metformin with sulfonylurea in 24.0%, DPP-4 inhibitor-based therapy in 18.0%, insulin-based therapy in 20.0%, and SGLT2 inhibitor-based therapy in 12.0%. Overall mean HbA1c was 8.2 ± 1.4%. Insulin-based therapy was associated with higher HbA1c, higher triglycerides, lower eGFR, and higher albuminuria, whereas SGLT2 inhibitor-based therapy showed comparatively favourable glycaemic and lipid parameters. Conclusion: Antidiabetic drug therapy showed significant association with glycaemic, lipid, and renal biochemical markers. Poorer profiles among insulin-treated patients reflected greater disease burden and longer diabetes duration rather than a direct drug effect. Recommendations: Routine integrated assessment of HbA1c, lipid profile, eGFR, and albuminuria is recommended during diabetes follow-up.
Background Caregivers of patients with head and neck cancer (HNC) may experience substantial burden and impaired quality of life due to prolonged caregiving demands. However, this association remains underexplored in Indian settings.Objectives: To assess caregiver burden and quality of life among primary caregivers of HNC patients and examine their association with sociodemographic and clinical variables. Methods This cross-sectional observational study was conducted over 18 months among 124 primary caregivers of histopathologically confirmed HNC patients admitted to a tertiary care institute in Rajasthan, India. Caregiver burden was assessed using the Zarit Burden Interview (ZBI), and caregiver quality of life using the Caregiver Quality of Life Index-Cancer (CQOLC). Data were analysed using IBM SPSS version 25. Mann-Whitney U, Kruskal-Wallis, Chi-square, Fisher's exact tests, and Spearman correlation were used, with p<0.05 considered significant. Results The mean ZBI score was 40.1 ± 15.9; 41.1% of caregivers reported mild-to-moderate burden, 21.8% moderate-to-severe burden, and 17.7% severe burden. The mean CQOLC score was 102.14 ± 27.59 and declined progressively with increasing burden, from 123.83 ± 11.24 among caregivers with little/no burden to 68.46 ± 26.18 among those with severe burden (p<0.001). ZBI score showed a strong negative correlation with CQOLC (r = −0.708, p<0.001). Caregiver burden was significantly associated with education, marital status, relationship to patient, socioeconomic class, patient care dependency, cancer stage, health insurance status, and treatment modality (p<0.05). CQOLC scores were significantly lower among caregivers of patients with greater care dependency, advanced cancer stage, absence of health insurance, and surgical treatment (p<0.05). Conclusion Caregiver burden is common among primary caregivers of HNC patients and is strongly inversely associated with quality of life. Recommendation Routine screening for caregiver burden and provision of psychosocial and financial support should be integrated into comprehensive HNC care.
Background: Multimorbidity, defined as the coexistence of two or more chronic conditions, is increasingly prevalent among the elderly in India. It significantly impacts healthcare utilization and financial burden, yet remains underexplored in integrated frameworks combining epidemiology, health economics, and patient perspectives. Objectives: To estimate the prevalence and patterns of multimorbidity, assess out-of-pocket expenditure (OOPE), evaluate healthcare utilization, and explore patient experiences among elderly individuals in rural and urban settings. Methods: A community-based mixed-methods study was conducted among 600 elderly participants (≥60 years) selected through multistage stratified sampling in Rural and Urban field practice area of Mahabodhi medical college Gaya ji. Quantitative data included socio-demographic characteristics, morbidity profile, healthcare utilization, and expenditure. Multimorbidity patterns were analyzed using cluster analysis. Logistic regression identified predictors. Catastrophic health expenditure was defined as OOPE ≥10% of household income. Qualitative data were obtained through in-depth interviews and analyzed thematically. Results: The prevalence of multimorbidity was 48.5% (95% CI: 44.5–52.5), higher in urban (54.2%) than rural areas (42.8%). The most common conditions were hypertension (58%), diabetes (42%), and osteoarthritis (37%). Three dominant clusters emerged: cardiometabolic, musculoskeletal, and respiratory. Multimorbidity was significantly associated with age ≥70 years (AOR 2.1), female gender (AOR 1.6), and low physical activity (AOR 1.9). Mean annual OOPE was ₹18,600, with 32% experiencing catastrophic expenditure. Private sector utilization was higher (61%), especially in urban areas. Qualitative findings highlighted financial distress, fragmented care, and lack of geriatric-friendly services. Conclusion: Multimorbidity poses a substantial clinical and economic burden among the elderly, with inequities across rural–urban settings. Strengthening primary care and financial risk protection is essential.
Introduction This study assesses the association between caretaker and household environmental characteristics and the prevalence of diarrhoeal diseases among U5s in Buhoma Town Council, Kanungu District, Uganda. Methodology A cross-sectional study was carried out between October and November 2025. It involved 322 adult caretakers aged 18 years and above, selected by simple random sampling. The data were analysed using the Stata Version 18 SE package. Generalised linear modelling was used to assess the strength of association between variables, and statistical significance was assessed at the 95% confidence level and p-value < 0.05. Results Most caretakers (44.1%) were aged 20–28 years, and over 50% of children were aged 24–59 months. Diarrhoea prevalence was 24.2% (95% CI: 0.19–0.29) in the previous two weeks. Higher prevalence was associated with having 2 (aPR=1.65, p=0.03) or 3 (aPR=3.40, p=0.03) under-five children, caretakers aged 29–35 years (aPR=2.43, p=0.04), caretaker history of diarrhoea (aPR=2.02, p=0.01), and movable handwashing facilities (aPR=1.76, p=0.02). Lower prevalence was associated with fourth income quartile (aPR=0.36, p=0.01), ever breastfeeding (aPR=0.39, p=0.02), age 12–23 months (aPR=0.51, p=0.04), uncovered water containers (aPR=0.36, p=0.001), and having a latrine/toilet in the dwelling (aPR=0.27, p<0.001). Conclusion Approximately 20% of under-five children had diarrhoea in the previous two weeks. Having multiple under-five children, older caretakers, a caretaker history of diarrhoea, and movable handwashing facilities were associated with higher diarrhoea prevalence. Higher household income, breastfeeding, age 12–23 months, uncovered water containers, and having a toilet within the dwelling were associated with lower diarrhoea prevalence. Recommendations There is a need to strengthen targeted interventions for the prevention and control of childhood diarrhoea, particularly through improved hygiene and sanitation practices, appropriate breastfeeding, safe water handling, and health education for caretakers.
Background: Arthroscopic anterior cruciate ligament reconstruction restores knee stability in young active adults, but the preferred autograft remains debated. Hamstring tendon is widely used, whereas peroneus longus tendon has gained attention because of adequate graft size and acceptable donor-site profile. Objectives: To compare functional outcomes of peroneus longus autograft and hamstring autograft in arthroscopic ACL reconstruction among young Indian adults with isolated acute ACL tears. Methods: This randomized controlled study included 172 patients aged 18-40 years with clinically and MRI-confirmed isolated acute ACL tears. Participants were allocated equally to hamstring autograft or peroneus longus autograft reconstruction. Standardized arthroscopic reconstruction, graft-size criteria, fixation methods, and supervised rehabilitation were followed. Outcomes were assessed up to 36 months using KOOS4 as the primary outcome and KOOS subscales, SF-36, Tegner Activity Scale, Oxford Knee Score, clinical stability, and adverse events as secondary outcomes. Results: Eighty-six patients were randomized to each group. Three patients in the hamstring group and five in the peroneus longus group did not follow the rehabilitation protocol and were excluded from final analysis. The mean KOOS4 improvement from baseline to three years was 39.2 points in the hamstring group and 39.4 points in the peroneus longus group, with an absolute between-group difference of 0.2 points. The difference was not statistically significant. Secondary functional and clinical outcomes also showed no significant between-group difference. Conclusion: Peroneus longus autograft produced functional recovery comparable to hamstring autograft after arthroscopic ACL reconstruction in young active adults. Recommendations: Peroneus longus tendon can be considered a practical alternative graft when hamstring preservation or adequate graft diameter is clinically
Introduction: Sudden death remains a significant medicolegal challenge, and determining its underlying cause may be difficult without detailed autopsy examination. Histopathological evaluation can identify significant pathological changes that may remain undetected during routine medicolegal examination. Aim: To identify the causes of sudden death, assess histomorphological changes in various organ systems, and correlate pathological findings with the medicolegal cause of death. Materials and Methods: This prospective cross-sectional autopsy study was conducted in the Department of Pathology, Fakir Mohan Medical College, Balasore, Odisha, from June 2022 to May 2025. A total of 30 consecutive cases of sudden, non-traumatic deaths were included. Demographic details, clinical history, medicolegal cause of death, gross autopsy findings, and histomorphological findings were recorded and analyzed using descriptive statistics. Results: Among the 30 cases, the most common age group was 21–40 years, with a mean age of approximately 39 years. The cardiovascular system was the most frequently involved system (33.3%), followed by the hepatobiliary system (26.6%). The commonest pathological finding was hepatic steatosis (26.6%), followed by petechial hemorrhage and pulmonary congestion (22% each), while myocardial infarction was identified in 16% of cases. The medicolegal cause of death was inconclusive in 26.6% of cases, and discrepancy between medicolegal and pathological causes was observed in 20% of cases. Conclusion: Histopathological examination provides valuable additional information in sudden deaths and may help establish or clarify the cause of death when routine medicolegal autopsy findings are inconclusive. Recommendation: Routine histopathological examination should be considered in sudden and unexplained medicolegal deaths to improve diagnostic accuracy and identify clinically unsuspected pathological conditions.
