Background: Laryngopharyngeal reflux (LPR) is an extraesophageal presentation of gastroesophageal reflux disease (GERD), characterized by reflux of gastric contents into the laryngopharynx. Symptoms often include chronic throat clearing, cough, hoarseness, globus sensation, and dysphagia, which frequently overlap with GERD presentations. Diagnosis remains challenging due to nonspecific symptoms and variable objective findings. Objective: To evaluate the correlation between clinical symptoms and laryngeal signs of reflux in patients with suspected LPR, and to compare clinical scoring systems (RSI/RFS) with standard reference criteria for LPR diagnosis. Methods: A prospective cohort of 68 patients presenting with symptoms suggestive of LPR (e.g., throat clearing, cough, globus sensation, hoarseness) was enrolled. Inclusion criteria required RSI >13 and/or RFS >7. Participants underwent comprehensive clinical evaluation, including symptom questionnaires (RSI), laryngoscopic examination (RFS), and pharyngolaryngeal assessment. A control group of patients with low RSI/RFS scores was also evaluated for comparison. Results: The LPR cohort (n = 68) demonstrated significantly higher mean RSI and RFS scores compared with controls, indicating more severe symptoms and laryngeal findings. Common symptoms included frequent throat clearing, chronic cough, globus sensation, hoarseness of voice, and dysphagia. Endoscopic assessment showed laryngeal erythema, vocal cord edema, and other inflammatory changes more frequently in the LPR group. The Reflux Symptom Index correlated strongly with clinical suspicion of LPR, supporting its utility in symptom assessment; RFS was useful in identifying laryngeal signs, although neither score perfectly matched objective reflux measures. Conclusions: This study of 68 patients with suspected LPR confirms a strong association between clinical symptom burden (RSI) and laryngeal inflammatory findings (RFS), supporting the correlation between GERD/LPR and chronic throat symptoms. Although clinical scoring tools are helpful, objective measures remain essential for definitive diagnosis due to the nonspecific nature of symptoms.

Background Biological agents have revolutionized cancer treatment by offering targeted therapeutic effects with improved selectivity over conventional chemotherapy. However, real-world data on their utilization and safety in Indian tertiary care settings remain limited. This study aimed to evaluate the drug utilization pattern and safety profile of biologics in cancer patients. Methods A prospective, observational study was conducted over 18 months (July 2022-December 2023) at a tertiary care oncology center in eastern India. A total of 373 prescriptions were analyzed, of which 100 included biological agents and were evaluated in detail. Patients aged 15-70 years with confirmed malignancy were included. Data on demographics, cancer characteristics, drug utilization, and adverse events (AEs) were collected. The primary outcome was the percentage utilization of biologics, while secondary outcomes included comparison of AE incidence between biologics and conventional therapy, and severity assessment using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results Biologics were prescribed in 26.8% of total prescriptions. The majority of patients were aged 46-70 years, with a slight female predominance. Breast, lung, and colorectal cancers were the most common malignancies, with most patients presenting at Stage III. Bevacizumab (30/373, 8.04%) was the most frequently used biologic, followed by trastuzumab (27/373, 7.24%) and rituximab (16/373, 4.29%). AE analysis showed that gastrointestinal toxicities such as nausea and vomiting were significantly higher with conventional therapy (61/373, 22.34% vs. 12/100, 12.00%, p=0.03), and neuropathy was also more common (45/273, 16.48% vs. 7/100, 7.00%, p=0.02). In contrast, biologics were associated with significantly higher hematological toxicities, including anemia, neutropenia, thrombocytopenia, and lymphocytopenia (p<0.001), as well as pneumonitis (15/100, 15.00% vs. 11/273, 4.03%, p=0.0008). Most AEs were mild to moderate, with no fatal events reported. Conclusion Biologics represent an important component of cancer therapy with an acceptable safety profile. While they reduce gastrointestinal and neurological toxicities, they are associated with higher hematological AEs and pneumonitis, emphasizing the need for careful monitoring.

IntroductionA key stage in the development of almost all types of malignancies is the dysregulation of telomeres and telomerase (hTERT). It has been suggested that arsenic-mediated changes in gene methylation status can mute tumor suppressor genes or increase oncogene expression, resulting in long-term alterations in the activity of genes governing cell transformation. Recent study demonstrated that, long-term exposure to an environmentally relevant dose of arsenic affects cellular development by interfering with the Hippo signaling system. The current study’s objective is to ascertain the underlying molecular cause of arsenic induced telomerase alteration and how it is associated with gene methylation.MethodTwenty-eight female with intermittent breast cancer from arsenic exposed areas were selected, after surgery, a sample of the tumor and the healthy tissue (which serves as a control group) were extracted for further processing. Arsenic concentration was analyzed by atomic absorption spectrometry. Western blotting and RT-PCR were used to analyze the telomerase expression. Additionally, MS-PCR was used to identify the genetic and epigenetic changes, respectively.ResultAccording to our research, 65% of female breast cancer patients had extremely high arsenic concentrations with elevated telomerase expression. The cause of this up regulation of telomerase expression is hTERT promoter hypomethylation.DiscussionThe findings also demonstrated a substantial association between breast cancer patients’ upregulation of hTERT and their exposure to arsenic and fine-needle biopsy specimens may provide further predictive information. Higher telomerase expression was associated with a worse outcome.

Background and aim Multidrug-resistant organisms (MDROs) represent a major global public health concern, largely driven by inappropriate antibiotic use, over-the-counter availability of antimicrobials, and the absence of effective prescription audit systems. MDROs are microorganisms, most commonly bacteria, that exhibit resistance to one or more classes of antimicrobial agents. The burden of multidrug-resistant infections has increased worldwide, with marked rises in both healthcare-associated and community-acquired infections, particularly in regions with high levels of antibiotic misuse. This study aimed to characterize the spectrum of MDROs circulating in a tertiary care center, identify associated risk factors, and describe their antibiotic susceptibility patterns. Methods A prospective observational study was conducted over a period of one month, involving 1,223 clinical specimens from predefined areas. Specimens were processed for culture, identification, and antibiotic susceptibility testing. For all samples, patient demographic details, clinical information, and risk factors were documented and assessed. Infection prevention and control-related information was also documented. Data were analyzed using IBM SPSS Statistics for Windows, version 22.0 (released 2013; IBM Corp., Armonk, NY, USA), with the incorporation of the chi-square test for comparison between categorical variables, and a p-value of < 0.05 was considered statistically significant. Results Of the 1223 specimens, 1020 specimens were culture positive, with 240 (23.52%) yielding MDROs, with the highest proportions isolated from peritoneal fluid, CSF, and pus. Escherichia coli was the most common MDRO, with 73 (30.4%) isolates, followed by 37 (15.4%) isolates of Klebsiella spp., 29 (12.1%) isolates of Pseudomonas spp., and 19 (7.9%) isolates of Acinetobacter spp. The majority of MDROs were isolated from general wards, with 112 (46.7%) MDROs rather than 47 (19.6%) MDROs from the critical care unit. Conclusions This study highlights the significant burden of MDROs in a tertiary care center, with a high proportion of resistance to last-line agents. The findings emphasize the need for regular surveillance, strict adherence to infection control practices, and effective antimicrobial stewardship programs to mitigate the growing MDRO burden. Future recommendations include establishing robust antimicrobial stewardship programs, conducting periodic hospital-specific antibiogram reviews, and promoting research on emerging resistance mechanisms.

There is a growing and urgent worldwide need to reduce the number of children under 12 years of age using drugs. The Child Intervention for Living Drug-Free (CHILD) curriculum has been developed and implemented around the world to help clinicians treat children between the ages of 4-12 for drug use problems. The aim of the present study is to determine the barriers and benefits of the Child Intervention for Living Drug-Free for children enrolled in residential treatment for drug problems, for their parents/caregivers, and for the staff providing care to the children. Within two treatment programs operated by the Society for the Promotion of Youth and Masses (SPYM) in New Delhi, India, six focus groups were conducted. Focus group 1 had n=15 children, focus group 2 had n=8 children, focus group 3 had n=12 parents/caregivers, focus group 4 had n=6 parents/caregivers, focus group 5 had n= 7 parents/caregivers and focus group 8 had n=8 staff. Findings revealed that children valued interactive, expressive activities that promoted personal growth and emotional well-being. Caregivers reported improvements in their child’s behavior but voiced concerns about their child’s possible future return to substance use, the impact of stigma on their families, and the lack of educational and vocational support in their communities. Staff praised the Child Intervention for Living Drug-Free curriculum’s engagement strategies but suggested simplifying content and increasing the use of visual and activity-based tools. Common themes across groups emphasized the importance of emotional resilience, decision-making skills, family support, and life skills linked to future employment. This qualitative evaluation underscores the importance of developmentally appropriate, family-centered, and community-supported approaches to child substance use treatment. While these findings are rooted in the Indian context, the challenges and solutions resonate globally. Given similar risk factors in the U.S., including lack of community support and peer pressure, the Child Intervention for Living Drug-Free curriculum offers a promising, adaptable model for early intervention especially for illicit drugs like fentanyl. Broader implementation and further research are recommended to support its effectiveness across diverse cultural settings.

Objectives: Chronic use of non-steroidal anti-inflammatory drugs(NSAID’s) is often limited by their side effect, necessitating the development of safer therapeutic alternatives. Apigenin, A plant flavonoid, has shown potential in enhancing the efficacy of NSAIDs while potentially reducing their adverse effects. This study aimed to evaluate the synergistic effects of apigenin combined with a subtherapeutic dose of diclofenac on inflammation in a rat model, to determine whether such a combination can improve anti-inflammatory effectiveness and reduce the drug dose required. Materials and Methods: A total of 42 Wistar albino rats were randomised into seven groups to receive various treatments including control (normal saline), standard diclofenac (100 mg/kg), three doses of apigenin (10, 20 and 40 mg/kg), a subtherapeutic dose of diclofenac (50 mg/kg) and a combination of apigenin (20 mg/kg) with diclofenac (50 mg/kg). Inflammation was induced using carrageenan, and paw volume was measured at multiple time points to assess oedema. The percentage change from baseline paw volume and percentage protection against paw oedema was calculated for each group. Results: The study found that the combination of 20 mg/kg apigenin with 50 mg/kg diclofenac significantly enhanced the anti-inflammatory response, achieving a peak reduction in paw volume of up to 49.66% at 3 h post-administration. This was superior to the responses seen with apigenin or diclofenac alone, where the maximal dose of apigenin (40 mg/kg) only managed a peak reduction of 28.18%, and the standard dose of diclofenac (100 mg/kg) reached a peak inhibition of 66.66% at 6 h. The subtherapeutic dose of diclofenac (50 mg/kg), used alone, showed a lower peak effect of 21.47% at 3 h. These results underscore the enhanced efficacy of the combination therapy, potentially allowing for lower doses of diclofenac while maintaining effective anti-inflammatory action. Conclusion: The findings suggest that combining apigenin with diclofenac enhances anti-inflammatory responses, supporting the potential of flavonoid-NSAID combinations as more effective and safer anti-inflammatory therapies. Future studies should explore the long-term effects and mechanisms of action to fully understand the benefits and limitations of such combinations in managing chronic inflammation.

Background Fetal growth restriction (FGR) is a significant perinatal concern associated with increased neonatal morbidity and long-term pediatric complications. Maternal high-risk factors such as hypertension, diabetes, malnutrition, and infections are known contributors to FGR. Objectives - To clarify the relationship between maternal high-risk variables and the pediatric effects of FGR. - To evaluate the pediatric outcome after 1-year follow-up. Methods A prospective observational study was conducted at IGIMS, Patna, over 1.5 years involving 92 FGR neonates. Maternal risk factors and neonatal outcomes were recorded, with follow-up assessments up to 12 months to evaluate growth and development. Results A total of 92 neonates with fetal growth restriction (FGR) born to high-risk mothers were enrolled. The mean maternal age was 28.4 ± 4.7 years; 48.9% were primiparous. Hypertensive disorders (52.2%) and diabetes mellitus (19.6%) were the most common maternal risk factors. Neonatal outcomes included hypoglycemia (37.0%), respiratory distress (31.5%), and NICU admission (55.4%). Significant correlations were found between maternal hypertension and NICU admission (p=0.003), and between diabetes and neonatal hypoglycemia (p=0.001). At 12-month follow-up, 29.3% had delayed developmental milestones, and 33.7% showed persistent growth impairment, indicating a strong association between maternal risks and adverse pediatric outcomes. Conclusion Maternal high-risk conditions significantly affect both immediate and long-term outcomes in FGR neonates. Early antenatal intervention and structured pediatric follow-up are essential to improve prognosis.

Background: Nephrotic syndrome (NS) in children often leads to alterations in serum biochemical parameters, including vitamin D and albumin levels. This study investigates the serum vitamin D levels during active nephrosis in children with NS and its correlation with serum albumin levels. Methods: This two-year observational cross-sectional study analyzed children diagnosed with nephrotic syndrome, focusing on their serum vitamin D and albumin levels. The study period spanned from start year to end year. We collected data on mean, standard deviation (SD), median, interquartile range (IQR), and range for both parameters. Given the non-normal distribution of vitamin D levels across the different NS patterns, we used the non-parametric Kruskal-Wallis test for group comparisons. Results: The mean (SD) serum albumin level was 1.28 (0.29) g/dL, with a median (IQR) of 1.20 (1.1-1.4) g/dL, ranging from 0.8 to 4.1 g/dL. The median vitamin D was (IQR) of 4.85 (3.02-6.47) ng/dL, ranging from 0.1 to 25 ng/dL. There were no significant differences in vitamin D levels between these groups (χ2 = 0.406, p = 0.939). Conclusion: Serum vitamin D levels do not significantly differ across various patterns of nephrotic syndrome in children. Additionally, there is no statistically significant correlation between serum vitamin D and albumin levels (rho = 0.01, p = 0.891). These findings suggest that vitamin D deficiency in children with nephrotic syndrome is independent of their serum albumin status and the pattern of the disease. Keywords: Nephrotic syndrome, Children, Serum vitamin D, Serum albumin, Biochemical parameters

Over the past decades, there is a dramatic rise in the mortality and incidence rates of breast cancer globally, despite the progressive advancement of therapeutic options. Late detection of breast cancer is often the main culprit for the ineffective treatment, and death in patients. Finding breast cancer biomarkers is thus of significant importance. Epigenetic modifications are associated with up and down regulation of important biomarker in the TGF-β pathway, such as SMAD4, which may have a greater impact in the growth and poor prognosis in breast cancer. In the current investigation we are going to check how SMAD4 regulate in various Breast cancer patients? And how its epigenetic modifications play crucial role in disease prognosis? Twenty eight samples of patients with proven breast cancer and the adjacent normal tissue from the same patients were analyzed for SMAD4 expression using real-time PCR and Western blot. Additionally, MS-PCR was employed to detect the epigenetic and genetic alterations. SMAD4 expression dropped from Grade 1 to Grade 3 breast cancer both at mRNA and protein level as justified by real time PCR as well as western blot. This down regulation of SMAD4 expression is due to its promoter methylation, which may be a major contributing reason to the dysregulated production of SMAD4 in instances of breast cancer. According to these findings, SMAD4 status assessment in breast cancer, fine-needle biopsy specimens may offer further prognostic data. Worse prognosis was linked to reduced SMAD4 expression due to promoter methylation in Breast cancer.

Background:Diabetes mellitus is a prevalent metabolic disorder characterized by reduced insulin activity leading to hyperglycemia, affecting over 425 million people globally. Traditional treatments, including sulfonylureas and biguanides, often have undesirable side effects, prompting a shift toward herbal remedies for diabetes management and prevention. Objective:This study aims to evaluate the antidiabetic effects of budding leaves from Clerodendrum infortunatum compared to metformin in preventing streptozotocin (STZ)-induced hyperglycemia in rats. Materials and Methods:An in vivo study was conducted using adult male Wistar albino rats. STZ was administered on day 15 and was followed till day 18. Methanolic extract of C. infortunatum (MECI) at different dosages (250, 500, and 1000 mg), metformin (500 mg), and normal saline were administered to different groups of rats. Blood glucose levels (at day 1, 15, and 18) and biochemical parameters (lipid profile, hepatic and renal parameters, and oxidative stress markers) were measured at days 1 and 18. At the end, a histopathological examination of the pancreas, liver, and kidney was done. Statistical analyses were performed to determine significance. Results:The study found that while the MECI at 500 mg/kg showed a significant reduction in blood glucose levels compared to the diabetic control group (P < 0.0001), it was less effective than metformin (P > 0.05). Higher doses of MECI demonstrated potential in improving liver and renal parameters (P < 0.0001), as well as reducing oxidative stress (P < 0.0001) compared to metformin indicating its beneficial effects in diabetic conditions. Conclusion:C. infortunatum shows promise as an adjunctive therapy for the prevention of diabetes due to its multifaceted mechanisms, including enhancing insulin secretion and reducing oxidative stress. However, further clinical trials are needed to confirm these findings and establish optimal dosages.

Bowen's disease is a non-melanocytic in situ squamous cell carcinoma of the epidermis. Having a multifactorial etiology, its incidence has been found to be the highest in Caucasians. It commonly occurs as a solitary lesion in the elderly on the photoexposed areas of the skin, mainly in the head and neck region. We present a case of a single, pruritic, oozy ulcerated lesion in the left upper labia majora in a 32-year-old female for the last six months who had undergone various treatments before presenting to our institute. Excision followed by histopathological examination led to the diagnosis of Bowen's disease. Our case focuses on the potential of Bowen's disease to mimic common dermatological lesions, and therefore a high degree of suspicion assisted by histopathological examination is essential for early and rapid diagnosis, along with a multimodality approach to management.

Background: Sūryanamaskār (Sun Salutation) is a dynamic sequence of yoga postures that integrates movement, breath, and awareness. It is widely practiced for its physical, mental, and spiritual benefits. Variations in speed and intensity can influence its physiological and psychological effects. Anxiety and fatigue are prevalent concerns among college students due to academic pressure and lifestyle factors while Yoga has been recognized as an effective intervention for stress reduction, the comparative impact of slow and fast Sūryanamaskār on anxiety and fatigue remains underexplored. Aim: This study aims to compare the effects of slow Sūryanamaskār with awareness and proper breathing versus fast Sūryanamaskār on anxiety and fatigue levels in college students. Materials and Methods: The study followed an interventional pre-test and post-test design, involving 80 students from Dr. Shyama Prasad Mukherjee College of Physical Education, Nurpur, Kangra, Himachal Pradesh. Participants were randomly assigned to two interventional groups: Group A (Fast Sūryanamaskār) – 40 students and Group B (Slow Sūryanamaskār) – 40 students. Anxiety levels were assessed using the Beck Anxiety Inventory, and fatigue levels were measured through the Fatigue Severity Scale. Both assessments were conducted before and after the intervention. Intervention: Participants engaged in an 8-week structured yoga program, practicing 6 days a week under the supervision of a certified Yoga instructor. Group A (fast Sūryanamaskār) performed 36 rounds at a pace of 30 s/ round, emphasizing speed and rhythm rather than awareness. Group B (Slow Sūryanamaskār) performed 36 rounds at a pace of 1 round/min, focusing on breath awareness and mindfulness. Each session included 10 min of Sukshma Vyayama (preparatory exercises) and 4 minutes of Shavasana (relaxation) post-practice. Results: The statistical analysis using paired and independent t-tests showed that: Group A exhibited a minor reduction in anxiety (pre-test mean = 26.99, post-test mean = 25.79; t = 1.0709), but it was not statistically significant. Group B showed a significant reduction in anxiety (pre-test mean = 26.75, post-test mean = 21.32; t = 3.3837, P < 0.05). Asimilar pattern was observed for fatigue levels, with GroupB demonstrating a highly significant reduction compared to GroupA. Conclusion: The study highlights that slow-paced Sūryanamaskār is significantly more effective in reducing anxiety and fatigue compared to its fast-paced counterpart. The intensity and physiological engagement of slow Sūryanamaskār likely contribute to its superior benefits. Future research should investigate the neurophysiological mechanisms and long-term impacts of these variations on mental health.

Introduction Triple -negative breast cancer (TNBC) is a new concept and an important area of investigation. In Western country's literature, different studies reported on TNBC and all indicated the poor prognostic aspect of this molecular subtype over other types of breast cancer. However, there is a scarcity of comprehensive data from India. Hence, the present study was carried out to look at the epidemiological and clinical characteristics of TNBC in the Indian population. Methods The present study was performed between January 2020 and June 2021 at a tertiary care hospital in Eastern India. A total of 150 patients with TNBC were enrolled in the study. The epidemiological and clinical features of enrolled patients were collected and reviewed. Results The median age of patients at TNBC presentation was 45.53 years (24 to 74 years). The median tumor size was reported to be 5.32 cm. Of 150 patients, 94(62.67%) showed enlarged lymph nodes and 56 (37.33%) patients had no lymph node enlargement. In the present study, 85 (56.67%) patients were in the pre/perimenopausal stage at presentation, whereas 65 (43.33%) patients were in the postmenopausal stage. Upon evaluating the spread of TNBC, it was observed that a maximum of patients 60 (40%) were at the T4 stage and 56 (37.33%) at the N0 condition. The clinical staging of TNBC reported a maximum of 74 (49.33%) patients at the IIA, and IIB stages followed by 53 (35.33%) patients at the IIIA, IIIB, and IIIC stages and a minimum of 11 (7.33%) patients at stage IV. Only five (3.33%) patients were reported with a family history of breast cancer. Of all patients, 126 (84%) had detected early breast cancer thereby applicable for surgery at the time of presentation, whereas 71 (47.33%) patients were eligible for radiation therapy and 138 (92%) patients received chemotherapy. A total of 112 (74.67%) patients were found alive after 24 months of follow-up, 22 (4.67%) patients were observed with remission, and 11 (7.33%) patients died due to TNBC progression. During the course of follow-up, five (3.33%) patients were lost in the study. Conclusion TNBC is an aggressive malignancy that has a high risk of systemic relapses in the first two years after diagnosis. For more mature evidence on TNBC, longer follow-up of patients is necessary.

यह शोधपत्र स्वतंत्रता के बाद से भारत में चुनावी राजनीति में आए परिवर्तनों की जांच करता है, विशेष रूप से लोकतांत्रिक प्रक्रिया में हाशिए पर पड़े समूहों, खासकर दलितों और अन्य पिछड़ा वर्ग (ओबीसी) के बढ़ते सहभागिता पर केंद्रित है, विशेष रूप से बिहार में। स्वतंत्रता से पूर्व चुनावी राजनीति पर उच्च वर्ग और उच्च जाति के नेताओं का प्रभुत्व था, लेकिन डॉ. बी. आर. अम्बेडकर जैसी हस्तियों ने वंचित वर्गों के राजनीतिक सशक्तिकरण की वकालत की। यह लेख इस आंदोलन के विकास को दो मुख्य चरणों में विभाजित करता है: पहला, 1967 से 1990 तक, जिसमें उत्तर प्रदेश और बिहार जैसे क्षेत्रों में ओबीसी और दलितों के राजनीतिक सशक्तिकरण पर ध्यान केंद्रित किया गया, जिसमें कर्पूरी ठाकुर, कांशीराम और राम मनोहर लोहिया जैसी हस्तियों की प्रमुख भूमिका रही। इसमें बिहार के उस समय के राजनीतिक अस्थिरता का भी विश्लेषण किया गया है, जिसमें अग्रणी और पिछड़ी जातियों के बीच सत्ता संतुलन में बदलाव, जाति आधारित सक्रियता का उदय और धन और सत्ता का प्रभाव शामिल है।

Post-vaccination myocarditis is usually moderate and transient, recovering quickly with conservative treatment. Therefore, it is of interest to assess for arrhythmia after CoViD-19 vaccination among Indians. We looked for ECG abnormalities in a small cohort of 50 participants after 52 weeks after receiving the Oxford/AstraZeneca CoViD-19 vaccination. Data shows that post-vaccination myocarditis is typically mild and transient, with most cases resolving swiftly through conservative management. Thus, it is unlikely that this vaccine will induce severe arrhythmias or life-threatening cardiac events in the general population.

Background: Antibiotics are the most commonly used drugs to treat bacterial infections; however, these lifesaving drugs can also cause adverse drug reactions. In several pharmacovigilance studies, adverse drug reactions are a cause of prolonged hospitalization. The development of hypersensitivity reactions even after a negative skin test and patch test makes antibiotic-associated adverse reactions unpredictable. Owing to the scarcity of data on antibiotic desensitization, these drugs are important for pharmacovigilance. Most of the previous studies conducted were retrospective and lacked data regarding the duration of adverse drug reactions. Aim: This study aimed to examine adverse drug reactions associated with antibiotics and to provide knowledge on the duration of these reactions. Method: A prospective observational study was conducted on patients receiving antibiotics at a tertiary care hospital. The patients were followed until discharge, and causality and severity assessments were performed. Descriptive statistical analyses were performed to summarize the data. Results: The study results show the median duration of adverse drug reactions was two days, with an interquartile range of two to four days. Most (21,3%) of the reactions were caused by cephalosporins. The majority (44.7%) of the reactions were skin and subcutaneous tissue disorders. The majority (78.7%) of the reactions were moderately severe and were not responsible for prolonged hospital stay. Conclusion: The patients receiving antibiotics require close monitoring for early detection and management of adverse reactions to reduce the duration of hospital stay and the duration of adverse drug reactions.

It is well known that E. officinalis (Amla) has anti-oxidant, tonifying, anti-aging, detoxifying, and anti-cancer properties in addition to acting as a broad spectrum antibiotic against various infectious diseases. This wonder plant contains antioxidants which aid in the clearing of toxins from the body (The liver is where toxins are found in abundance) and may also protect the liver from the resulting damage. However, the effects of E.officinalis on normal human liver cells along with cancer human liver cells remain largely unknown. The purpose of this study is to look into the hapto-protective and anticancer effects of E. officinalis on normal as well as cancer liver cell line. approaching the same, aqueous extract of E. officinalis fruit extract was prepared for anticancer screening. The hepatoprotective and anticancer effect of amla on cell viability, cytotoxicity and cell proliferation of normal human liver cells (Wrl-68) and cancer human liver cell (HepG2) was analyzed using trypan blue dye exclusion test, MTT WST assay as well as by fluorescent staining with PI DAPI. ROS and Apoptosis was analyzed by DCFDA and Annexin V/PI assay and expression of apoptosis-regulating proteins was evaluated by immunoblotting. The study demonstrated that 50 μg/ml of fruit extract of E.officinalis inhibited cell viability and induced cytotoxicity, simultaneously triggers apoptosis in cancer cells by generation of intracellular ROS species in HepG2 cells without any toxic effect on normal liver cell after 48 h of incubation. E.officinalis fruit shows tremendous pharmacological and medicinal application along with cheap or cost effective clinical validation for the treatment of both organ specific tumors as well as for various types of leukemia.

Abstract Background This study aimed to assess the factors influencing health-related quality of life (HRQoL) in patients experiencing adverse drug reactions (ADRs) at a tertiary care public sector hospital. A cross-sectional study was conducted over a period of 18 months, and included both male and female patients aged 18 years and above. Patients who visited the outpatient and inpatient departments with complaints associated with ADRs were included in this study. HRQoL data were collected using the EuroQol—5 Dimension—5 Level (EQ-5D-5L) questionnaire to assess five dimensions of health on a five-level scale. Descriptive statistics, t-tests, and analysis of variance were used to analyze the data. Multivariate regression analysis was performed to identify the potential determinants of HRQoL. Results A total of 316 patients were included in the study among these participants, of which 54% were female, and 65% were from rural areas. The majority (68%) of the patients had moderately severe ADRs, and 63% of the participants had an income < 2.5 lakh Indian rupees (3009 USD). The mean EQ-5D-5L and EuroQoL Visual Analog Scale (EQ VAS) scores of the study participants were 0.714 and 69.73, respectively. The variables ADR severity, income, and age showed a significant difference (p < 0.05) in HRQoL. Conclusion This study provides insights into HRQoL among patients with ADRs and identifies the determinants of HRQoL. The findings of this study will contribute to improving patient-centered care and optimizing patient outcomes.