Background: Surgical menopause caused by bilateral oophorectomy before the natural age of menopause leads to abrupt estrogen deprivation. Estrogen plays a crucial role in maintaining bone remodeling balance by inhibiting osteoclastic bone resorption and preserving bone mineral density (BMD). Women undergoing early surgical menopause may therefore experience accelerated bone loss and increased fracture risk compared with women attaining natural menopause. Aim: To evaluate the impact of early surgical menopause on bone mineral density and incident fracture risk in women followed prospectively for three years. Materials and Methods: This prospective hospital-based study included 220 women aged 35–50 years. Group A comprised 110 women who underwent bilateral oophorectomy with or without hysterectomy before age 45 years. Group B included 110 age-matched women with natural menopause or regular ovarian function. Baseline and annual assessments included dual-energy X-ray absorptiometry (DEXA) of lumbar spine and femoral neck, serum calcium, alkaline phosphatase, and fracture surveillance. Statistical analysis was performed using t-test, chi-square test, repeated measures ANOVA, and Cox regression. Results: At baseline, mean lumbar spine BMD was significantly lower in Group A than Group B (0.918 ± 0.11 vs 0.982 ± 0.10 g/cm², p<0.001). At three years, mean decline in lumbar spine BMD was 8.6% in Group A versus 3.1% in Group B (p<0.001). Osteoporosis developed in 29.1% of Group A compared with 11.8% of Group B. Fragility fractures occurred in 14 women (12.7%) in Group A and 5 women (4.5%) in Group B (HR 2.84; 95% CI 1.03–7.81). Conclusion: Early surgical menopause is associated with accelerated bone loss and significantly increased fracture risk. Timely screening, calcium-vitamin D supplementation, lifestyle intervention, and hormone therapy where appropriate may reduce skeletal morbidity.

Background: Anemia and respiratory infections are major public health concerns among children in developing countries. Both conditions contribute significantly to morbidity and mortality, especially in low-resource settings. Objective: To determine the prevalence of anemia among pediatric patients and evaluate its association with respiratory infections. Methods: A hospital-based cross-sectional study was conducted among 200 children aged 6 months to 12 years attending the pediatric outpatient and inpatient departments. Hemoglobin levels were assessed using an automated hematology analyzer. Respiratory infections were diagnosed clinically and supported by relevant investigations. Statistical analysis was performed using chi-square tests and logistic regression. Results: The prevalence of anemia was found to be 58%. Respiratory infections were observed in 32% of children. A significantly higher proportion of respiratory infections was noted among anemic children compared to non-anemic children (p < 0.001). Moderate to severe anemia showed a stronger association with recurrent respiratory infections. Conclusion: Anemia is highly prevalent among pediatric patients and is significantly associated with respiratory infections. Early detection and intervention are essential to reduce the burden of disease.

Background: Acute cholecystitis is a common surgical emergency. The optimal timing of cholecystectomy—early versus delayed—remains a subject of debate. Objective: To compare early and delayed cholecystectomy in terms of operative outcomes, complications, and recovery. Methods: A prospective observational study was conducted on 180 patients diagnosed with acute cholecystitis. Patients were divided into early (within 72 hours, n=90) and delayed (after 6–8 weeks, n=90) groups. Outcomes such as operative time, hospital stay, complications, and conversion rate were analyzed. Results: Early cholecystectomy showed shorter hospital stay and fewer readmissions, though operative time was slightly longer. Complication rates were comparable. Conclusion: Early cholecystectomy is safe, feasible, and associated with better overall outcomes.

Background: Chronic Otitis Media is the major cause of hearing impairment, mainly conductive type of hearing loss. The occurrence of sensorineural hearing loss (SNHL) in CSOM is controversial and the controversy is more for safe mucosal type. This study aims to assess the association between SNHL and safe mucosal CSOM and its relation to patient’s age, sex, duration of disease, active or inactive disease and speech frequencies.  Methods: 100 patients with unilateral mucosal type of CSOM with normal contralateral ear were included in the study. The infected ear was taken as study ear and normal ear as control ear in all patients. All patients underwent hearing assessment by pure tone audiometry for both ears. In case of active disease, ear discharge was first cleared and then audiometric assessment done. Results were statistically compared in all patients for both study and control ears using parameters of patient’s age, sex, duration of disease, speech frequency and active or inactive disease.  Results: There was significant higher number of study ears with CSOM having average bone conduction threshold of all frequencies above 25 decibels which implies SNHL (21%) compared to control contralateral ears without infection (5%). There was higher incidence of SNHL at higher speech frequencies. The incidence also increased with age of patient and duration of disease. The incidence was higher in active stage than inactive or quiescent stage. There was no difference among males and females.  Conclusion: Safe mucosal CSOM can cause significant SNHL and risk increases with increasing age, duration of disease, higher speech frequencies and presence of active disease.