Introduction: Dyslipidemia is a common comorbidity in patients with type 2 diabetes mellitus (T2DM), increasing the risk of cardiovascular diseases. This study compares the efficacy and safety of two combination therapies: atorvastatin plus fenofibrate versus atorvastatin plus saroglitazar in managing dyslipidemia in T2DM patients Materials and Methods: A randomized, open-label study was conducted on 90 T2DM patients with dyslipidemia. Patients were divided into two groups: Group A received atorvastatin (20 mg) plus fenofibrate (160 mg), and Group B received atorvastatin (20 mg) plus saroglitazar (4 mg). The study duration was 12 weeks. Efficacy was assessed by changes in lipid profiles, and safety was evaluated through adverse event monitoring Results: Both groups showed significant improvements in lipid parameters. Group B (atorvastatin plus saroglitazar) demonstrated superior efficacy in reducing triglycerides (TG) and increasing high-density lipoprotein cholesterol (HDL-C) compared to Group A. Safety profiles were comparable, with mild adverse events reported in both groups Conclusion: Atorvastatin plus saroglitazar is more effective than atorvastatin plus fenofibrate in improving lipid profiles in T2DM patients with dyslipidemia, with a similar safety profile.

Introduction: Oral health is identified as neglected health need of a population. Schools act as building blocks in shaping up the children’s behavior. Enhancing the levels of child’s knowledge by oral health education plays a pivotal role in improving oral health which in turn affects the overall health. Reinforcement is of utmost importance in retaining the established positive oral health behavior in the children. Aim: To assess the impact of oral health education on knowledge, attitude, practices among 12 -15 years old school children of Greater Noida. Materials and Method: A before-and-after experimental study was conducted among (n = 200) 12–15 year-old children from schools of Greater Noida, Gautam Budh Nagar from July 2018 to August 2018. At baseline, children were assessed for oral health knowledge, attitude and practices using a prevalidated self-administered structured questionnaire. Oral health education was delivered using audiovisual aids for 30 mins. Reinforcement was done using the same audiovisual aid on 15th day from the baseline for the study group and no filling of the questionnaire during this period was done. Children's oral health-related knowledge was checked by the same investigator using the same closed-ended questionnaire after 30 days of imparting oral health education to the study subjects.  Results: All the questions showed statistically significant improvement in knowledge, attitude and practices except “Oral Health Part of General Health” and “Regular cleaning of mouth can prevent dental caries”  which showed no improvement. Conclusion: It was concluded that repeated oral health education results in improved oral health knowledge, attitude and practice.

Background: Stress urinary incontinence (SUI) adversely affects women’s quality of life, necessitating effective surgical interventions. Objective: This study aims to evaluate the short- and long-term outcomes of urogynecological surgeries for SUI, comparing efficacy and patient satisfaction among different surgical techniques. Method: A prospective cohort study was conducted at Barasat Government Medical College, Kolkata, from January 2023 to December 2023. A total of 100 female patients diagnosed with SUI were enrolled and underwent urogynecological surgery, including midurethral sling (MUS), Burch colposuspension, and pubovaginal sling procedures. Patients were followed for one year post-surgery, with assessments at 3, 6, and 12 months. Outcomes measured included continence rates, postoperative complications, recurrence rates, and patient satisfaction using validated questionnaires such as the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Statistical analysis involved paired and independent t-tests, chi-square tests, and regression analysis, with significance set at p < 0.05. Result: At one-year follow-up, MUS demonstrated an 85% continence rate, Burch colposuspension 78%, and pubovaginal sling 80% (p=0.04). Complications were lowest in the Burch group (10%) compared to MUS (15%) and pubovaginal sling (12%) (p=0.35). Recurrence rates were 10% for MUS, 15% for Burch, and 12% for pubovaginal sling (p=0.40). Patient satisfaction was highest in the MUS group (80%), followed by pubovaginal sling (75%), and Burch colposuspension (70%) (p=0.03). Regression analysis revealed that MUS was a significant predictor of higher continence rates (β=0.30, p=0.02) after adjusting for age and baseline severity. Additionally, quality of life scores improved by 60% in MUS, fifty-five in Burch, and 58% in pubovaginal sling groups (p=0.05), indicating sustained benefits over the study period. Conclusions: Midurethral sling procedures offer superior continence rates and higher patient satisfaction with acceptable complication profiles compared to alternative surgical techniques for SUI. These findings support the preference for MUS in clinical practice to optimize patient outcomes.

Introduction: The study established the relationship of body inflammation with blood glucose levels in human beings classified into the three groups; patients having the normal blood sugar, mildly increased blood sugar levels and type-2 diabetes patients. The study also established the relationship between the increase in blood sugar problems and the increasing trend of aging, weight, and obesity among the people. Methods: Blood levels of inflammatory markers including C-reactive protein, interleukin-6, and tumor necrosis factor-alpha were estimated in diabetics compared with others. Adjustment for age, gender, and body weight showed that increased levels of the inflammatory markers correlated with poorer blood glucose control and insulin action. Results: Normal Blood Sugar, Mildly Increased Blood Sugar, and Type-2 Diabetes. There were statistically significant increases in age, BMI, obesity, C-Reactive Protein (CRP), Interleukin-6, Tumor Necrosis Factor-Alpha (TNF-α), physical activity, nutritional quality, hypertension, and hyperlipidemia when blood glucose levels dropped down below normal (p-value <0.001). In each of the three pairwise comparisons-Normal vs. Mildly Increased, Normal vs. Type-2 Diabetes, and Mildly Increased vs. Type-2 Diabetes-it can be observed that analysis of significant p values across the three groups shows consistent disparities in multiple variables. Conclusion: The results indicate that body inflammation plays a significant role in causing diabetes. As indicated earlier, diet and physical inactivity are lifestyle factors that contribute to the development of the disease. This study concludes that inflammation does not just happen because of diabetes but also plays an active role in the progression of diabetes. This understanding further makes early intervention into inflammation and modifications in lifestyle essential to prevent or more effectively manage type 2 diabetes and all its complications.

Background: Cardiorenal syndrome is group of disorder involving kidney and heart in which acute or chronic dysfunction of one organ may induce dysfunction of another organ. The study was to determine incidence, risk factor, hospital stay and outcome in cardiorenal syndrome in bundelkhand region in India.

Methods: This was single center observational study which included 119 patients admitted in ward, emergency from 1^st April 2020 to 30^th September 2021 in medicine department, maharani laxmibai medical college, Jhansi. Ronco et al, 2018 classification was used for classifying cardiorenal syndrome phenotype in these patients. Heart failure was diagnosed on bases of Framingham criteria, 2D Echo, NT-proBNP value. Kidney failure diagnosed on bases of USG finding, serum creatinine, E-GFR, urine routine result. Data was statistically analyzed using SPSS 24.0 and Microsoft excel 2019. Outcomes included in-hospital mortality, hospital stay and 6-month survival and 6-month readmission rate.

Result: out of 119 CRS patients 67.22 % were male. Type 1 CRS was most common with 41% followed by type 2, type 4, type 5 and type 3. Most common age group was 41-60 year (47%). Urban population is more affected (67%).  Most common comorbidity was hypertension (57.14%) followed by CAD and diabetes mellitus type 2. Most common risk factor was smoking 67% followed by dyslipidemia and sedentary life style. Most common symptom was dyspnea followed by chest discomfort and pedal edema. Mortality was seen 33.61% in these patients in 6 months duration. Most in-hospital mortality was seen in type 5 CRS (70%) followed by type 3 (33%).  Average hospital stay was 8 days. Readmission rate in patient who were discharged was 39.79%. Anemia, S. Creatinine, E GFR, S. Albumin, S. Sodium level and LVEF at time of admission were significant predictor of non-favorable outcome in our study.

Conclusion: Increasing average age and life style changes such as smoking, tobacco chewing, sedentary life style and stress are major risk factor for increasing incidence and prevalence in non-communicable disease such as systemic hypertension, diabetes mellitus type2, coronary artery disease and renal failure. This all-non-communicable disease associated with cardiorenal syndrome. Cardiorenal syndrome carries high mortality, morbidity and readmission rate. It’s putting immense load on hospital expenses now and in future this disease is going to put more burden on hospital expenses and government spending on healthcare.

Candida spp. is generally found in humans; however, when the host's immune system is compromised, the pathogen infects the host, earning it the name opportunistic pathogen. It can also be found on the surfaces of biomaterials such as catheters, Venflon, intravenous tubes, dentures, and blood bags in a medical setting. It infects people who have been admitted to the hospital. This causes major health problems for the patients and raises morbidity and mortality rates over time. Those who take antifungal medications for this infection on a regular basis acquire resistant to the drugs. Candida albicans and non-Candida albicans were found to predominate in distinct clinical samples in this investigation. The goal of this cross-sectional study, which took place at the Ramnath Prasad Hospital, Champaran, Bihar, for a Period of One Year from June 2023 to Maay 2024 was to determine the burden of catheter associated urinary tract infection by candida albicans and non albicans with emphasis on biofilm formation. CAUTI is a prevalent complication in critically ill individuals. In order to reduce the incidence of catheter-related UTI, the focus should be on appropriate catheter maintenance and lowering catheterization length rather than prophylactic. In the treatment of CAUTI, culture and susceptibility testing are crucial

Background: Pre-eclampsia is a hypertensive pregnancy disorder that increases the risk of long-term cardiovascular complications. Its long-term influence on cardiovascular health remains underexplored. Objective: This study investigates the cardiovascular health outcomes in women with a history of pre-eclampsia, assessing risk progression over time compared to women with normotensive pregnancies. Method: A longitudinal study was conducted at Barasat Government Medical College & Hospital, India, from June 2022 to December 2023. The sample consisted of 100 women, 50 with pre-eclampsia and 50 with normotensive pregnancies. Cardiovascular parameters, including blood pressure, cholesterol levels, and arterial stiffness, were measured every six months post-pregnancy. Results: Among the pre-eclampsia group, 48% (n=24) developed chronic hypertension within the first 12 months postpartum, compared to only 12% (n=6) in the normotensive group. At the 18-month mark, 42% (n=21) of the pre-eclampsia group exhibited significant increases in arterial stiffness, compared to 14% (n=7) of the normotensive group. Dyslipidemia was observed in 38% (n=19) of pre-eclampsia patients and 10% (n=5) of normotensive women by the end of the study. Overall, the pre-eclampsia group had a 4.5 times higher likelihood of developing cardiovascular disease (p < 0.001). Conclusions: The results confirm that pre-eclampsia significantly increases the risk of long-term cardiovascular conditions. Comprehensive postpartum cardiovascular screening is crucial for women with a history of pre-eclampsia to prevent future complications.

Background: Musculoskeletal injuries are a leading cause of morbidity following trauma, particularly in developing regions like Varanasi, Uttar Pradesh. Trauma from road traffic accidents, falls, and occupational hazards is prevalent, making timely and accurate diagnosis crucial for effective treatment. X-ray and Magnetic Resonance Imaging (MRI) are key diagnostic tools, with X-ray being commonly used for detecting bone injuries, while MRI is superior for soft tissue and subtle injuries. However, there has been limited study on the comparative diagnostic patterns of these imaging modalities in trauma patients from this region. Materials and Methods: This prospective observational study was conducted on 200 trauma patients presenting with musculoskeletal injuries at selected hospitals and diagnostic centers in Varanasi, Uttar Pradesh. All patients underwent X-ray imaging as the first diagnostic tool, followed by MRI in cases where X-ray results were inconclusive or soft tissue injury was suspected. Data on patient demographics, types of trauma, and injuries detected through X-ray and MRI were recorded. The sensitivity, specificity, and diagnostic accuracy of both imaging techniques were compared using SPSS software, version 25.0. Results: Of the 200 patients, 64% were male, with the majority (33%) aged between 31 and 45 years. Road traffic accidents were the most common cause of injury (49%), followed by falls (33.5%). X-ray identified 142 bone fractures, while MRI detected 163, revealing subtle fractures missed by X-ray. Both modalities identified 32 dislocations. However, X-ray failed to detect any soft tissue injuries, while MRI diagnosed 61 ligament tears, 48 tendon injuries, 46 soft tissue contusions, and 24 cases of bone marrow edema. MRI demonstrated superior sensitivity (100%) for detecting fractures and soft tissue injuries compared to X-ray (89.7% for fractures, 0% for soft tissue injuries). Conclusion: This study highlights the limitations of X-ray in detecting soft tissue injuries and subtle fractures, reaffirming the importance of MRI as a complementary diagnostic tool. Incorporating MRI into trauma care protocols, especially for patients with inconclusive X-ray results or suspected soft tissue injuries, significantly enhances diagnostic accuracy and improves patient outcomes. Given the higher costs and limited availability of MRI, its use should be judiciously balanced with clinical indications.

Background and Aim: Echocardiography is crucial for identifying complications of endocarditis, such as perivalvular abscesses, aneurysms, fistulas, and ruptures of valvular leaflets, chordae, papillary muscles, or the interventricular septum. This observational study aimed to identify the microorganisms involved and the clinical profile of infective endocarditis in patients with rheumatic heart disease within the local population of Gujarat, assess the disease's response to medical treatment, and evaluate case prognosis. Material and Methods: The study involved 50 patients with rheumatic heart disease who met the diagnostic criteria for infective endocarditis. A comprehensive clinical history and physical examination, focusing on predisposing factors and complications, were conducted. Routine tests included a complete hemogram, urinalysis (particularly for microscopic hematuria), chest X-rays, and an EGG. A detailed M-mode and 2D echocardiographic study was performed for all suspected cases, with transesophageal echocardiography (TEE) conducted for ambiguous cases. Results: All patients exhibited mild to moderate fever (100%), with 22 patients (44%) presenting with congestive heart failure. Clubbing as a peripheral sign of infective endocarditis was noted in 18 patients (36%). All 50 cases showed decreased hemoglobin levels, and 6 patients were significantly anemic with levels below 7 g/dL. At admission, 25 patients had leukocyte counts exceeding 10,000 cells per cubic millimeter. Blood cultures were positive for 14 patients, while 36 tested negatives despite repeated samples over seven days; Staphylococcus aureus was the most frequently isolated organism, identified in 6 of 50 patients' blood samples.  Conclusion: he treatment of endocarditis was more effective when appropriate antibiotics were administered based on culture and sensitivity results rather than relying on empirical treatment. Infective endocarditis presents with nonspecific symptoms and clinical signs.

BACKGROUND: Psoriasis is an immune-mediated chronic systemic disease involving cytokines of helper Th1 pathway. Vitamin D has an effect on keratinocyte proliferation, differentiation and immune modulation of immune system especially Th1 pathway, which is altered in psoriatic skin suggesting that Vitamin D may have a role in pathogenesis of psoriasis.      AIMS AND OBJECTIVE:To evaluate serum vitamin D level in psoriasis cases and in control group and correlating vitamin D level with severity and duration of the psoriasis. METHODS AND MATERIALS:A cross sectional study of 110 cases of psoriasis was included from February 2022 to January 2023 after getting the approval from the institutional ethical committee and consent from the patient. Serum levels of calcium,    phosphorus,    parathyroid    hormone    (PTH),    alkaline phosphatase  (ALK)  and  25-  hydroxyl  vitamin  D3  [(25OH)  D3]  were measured  in  both  groups. RESULTS:Among110 patients with psoriasis 63 (57.27%) were men and 47 (42.72%) were women. There was no significant difference in the serum level of calcium (P-value: 0.552), phosphorus (P-value: 0.372), PTH (P-value: 0.353) and ALK (P-value: 0.648) between two groups. Vitamin D deficiency was found in 63.4 % of psoriatic patients and 58% of the controls (P-value=0.45); However 31.8% of psoriatic and 16.2% of the controls suffered from severe hypovitaminosis D. This difference was statistically significant (P-value=0.013). CONCLUSIONS: The study found a significant relationship between vitamin D and psoriasis. Vitamin D levels benefits patient with psoriasis vulgaris. This finding revealed the need for evaluation of  psoriatic   patients   for   the   presence  of   vitamin   D deficiency. Keywords: Psoriasis, Vitamin D, Calcium, Parathyroid hormone. 

Introduction: Treating of ESBL and MBL is becoming difficult and often resulting in therapeutic failure. ESBL and MBL pathogens can spread easily between species and they are coded by plasmid. Globally, the treatment options for ESBL and MBL are limited, as infections are common presentation in our patients and also in ICU patients. The aim of the present study is to isolate the pathogens from various clinical samples and to determine antimicrobial susceptibility pattern of isolates with a special focus on ESBL and MBL resistance mechanisms. Materials and Methods: All clinical samples fallen in acceptable criteria as per the lab policy were collected and received at the lab. All details pertaining to patients including age, sex, type of specimen, ICU admission number, socioeconomic status, previous history of hospitalization, antibiotic intake, organism isolated, sensitivity pattern of antibiotics was collected and entered into Microsoft excel sheet. All descriptive quantitative variables were expressed as numbers and percentages. Results: Among Urine samples, Escherichia coli (44.8%) was the commonest followed by Klebsiella species (20.5%) and Pseudomonas species (9.09%). Among all respiratory samples, the most common pathogen isolated was Klebsiella (43.7%) followed by Pseudomonas species (18.7%) and Acinetobacter species (16.6%). Blood samples showed Escherichia coli (42.8%) and Klebsiella species (42.8%) as the predominant pathogen. Fluids yielded the Escherichia coli (60%) and Klebsiella species (40%). 23.7% of pathogens are ESBL producers, most common being Klebsiella species and Escherichia coli. 9.09% of pathogens are ESBL producers, most common being Klebsiella species and Escherichia coli. Conclusion: Antibiotic resistance numbers increase in worldwide is creating a major public health problem, so central and government authorities should strengthen the antimicrobial stewardship program in all health care institutes and should create awareness on drug resistant management to all health care workers and other industries those are using antibiotics.

Transcatheter Aortic Valve Replacement (TAVI) has revolutionized the treatment of severe aortic stenosis, offering a less invasive alternative to surgical aortic valve replacement (SAVR). This article explores the future of TAVI, focusing on advancements aimed at improving valve durability, expanding indications to younger patients, and refining procedural techniques. Innovations in valve materials and design, coupled with advanced imaging and AI-driven tools, are poised to enhance the efficacy and safety of TAVI. These developments are expected to extend the longevity of TAVI valves, make the procedure more accessible to younger and low-risk patients, and streamline the overall process, promising a brighter future for aortic stenosis treatment.

Background: Heart failure (HF) manifests diversely, with albuminuria potentially marking worse prognosis. This study explores the relationship between albuminuria and the clinical profile of HF.

Methods: A prospective study was conducted from May 2023 to November 2024 at a tertiary care medical college hospital in Bangalore. A total of 64 HF patients were enrolled, including those with preserved, midrange, and reduced ejection fractions. Patients were assessed for albuminuria using the urine albumin/creatinine ratio and categorized into normoalbuminuria (<30 mg/g), microalbuminuria (30-299 mg/g), and macroalbuminuria (≥300 mg/g).

Results: Among the 64 HF patients, 37.5% had new-onset HF, and 62.5% had worsening HF.  Patients had 23.4% reduced EF, 39.1% had midrange EF, and 37.5% had preserved EF. 46.9% of patients had microalbuminuria and 45.3% had macroalbuminuria. Patients with preserved EF were significantly associated with macroalbuminuria (p=0.0014) and patients with midrange EF had statistically significant microalbuminuria (p=0.0018). Patients with NYHA class IV had significantly higher  macroalbuminuria (52.9%, p=0.0231). Patients with history of Diabetes mellitus, hypertension, and myocardial infarction were significantly associated with albuminuria (p<0.05). Basilar rales, peripheral oedema, hepatomegaly (p=0.0039), orthopnea, and jugular venous distension were significantly more common in patients with macroalbuminuria (p<0.05).

Conclusion: Albuminuria may serves as a marker of clinical congestion and severity of heart failure, highlighting the importance of assessing albuminuria in the clinical management of HF.

Background: Incidence of twin pregnancy is on increasing trend due to increase in assisted reproductive technology. Regardless of the efforts the improve well-being of the second twin, due to intra-partum events the outcomes are still not well established due to conflicting data.  Objective: To evaluate the obstetrical factors influencing the morbidity of the second twin. Methods: This Hospital based cross sectional, descriptive study was conducted in IPD of Obstetrics and Gynecology Department in Vani Vilas Hospital, BMCRI. Duration of study was February 2021 to August 2022. Results:  Perinatal morbidity of twin 2 was evaluated in comparison with NICU admission. Pre-term delivery, Chorionicity of DCDA, mode of delivery, APGAR score at 1 minute had significant association with NICU admission of twin 2. Conclusions: This study highlighted that perinatal morbidity and mortality outcome of twin 2. There is a paucity of standard protocol for management of twin pregnancy. This knowledge from our study would help our institute to make protocols to address the unmet need in management of twin pregnancy.

Background: Epidural anaesthesia is one of the preferred modes of regional anaesthesia for lower limb orthopaedic surgeries. This technique provides not only intra-operative surgical anaesthesia but also post-operative analgesia. Dexmedetomidine is a new drug with selective α2-adrenoceptor agonist when used as adjuvant to regional anesthesia showed analgesic, sedative, anxiolytic, sympatholytic properties. Aim: To evaluate and compare the efficacy of epidurally administered dexmedetomidine and fentanyl along with bupivacaine for patients undergoing lower limb orthopaedic surgeries. Method: The study was done among the study participants scheduled for lower limb orthopaedic surgery in Government Thanjavur Medical College by the Department of Anesthesiology. The study was done for a period from March 2023 to December 2023. Sixty study participants recruited based on inclusion and exclusion criteria. The enrolled study participants were randomized and allocated into two groups (30 each).

GroupBF- received 12ml of 0.5 % bupivacaine with 1 μg/kg of Fentanyl epidurally

 Group BD - received 12ml of 0.5 % bupivacaine with 1 μg/kg of dexmedetomidine epidurally.

Data collected were entered in MS Excel and the statistical analysis was done in SPSS 23.p value <0.05 is considered as statistically significant. Results:  The mean time for onset of T10 sensory block is 11.23 ± 1.32 (minutes)in group BF and 8.45 ± 1.57 (mins) in group BD. The highest sensory level of T5 was achieved in more number of patients in group BD compared to group BF.The time taken to attain maximum sensory level in group BF 18.13 ± 2.1 minswas compared to group BD 14.50 ± 1.78 mins.The time taken  for complete motor block was earlier in group BD 17.57 ± 2.84 minutes when compared to group BF 22.33 ± 3.43minutes.The two segment regression time was longer 129.7 ± 5.52 minutes in group BD compared to 93.25 ± 7.54 minutes group BF.Better sedation score was observed at group BD when compared to group BF.

Conclusion: When compared to fentanyl as an adjuvant to ropivacaine, intrathecal dexmedetomidine causes a faster onset of sensory and motor blockade and a longer duration of motor and sensory block, as well as hemodynamic stability, higher sedation, and a longer duration of post-operative analgesia

Background: Coronary artery disease (CAD) is a predominant cause of mortality worldwide and can present with a range of symptoms that may obscure diagnosis, particularly in younger patients. The variability in symptom presentation, coupled with the potential for misinterpretation of diagnostic tests, often leads to delays in appropriate treatment, thereby increasing the likelihood of adverse outcomes. This case report seeks to elucidate the complexities in diagnosing and managing CAD, especially in younger patients with atypical symptoms, by detailing the clinical experience of a 38-year-old patient diagnosed with CAD.

Case Illustration: A 38-year-old patient presented with chest pain and was evaluated at two separate hospitals. At the first hospital, initial diagnostic tests included an exercise stress electrocardiogram (ECG) and an echocardiogram. The stress ECG results indicated inducible ischemia, although the echocardiogram appeared normal. When the patient experienced recurrent chest pain, they sought further evaluation at a second hospital. There, an ECG detected ischemic changes, and subsequent blood tests corroborated the CAD diagnosis. After the patient's condition was stabilized, a coronary angiography (CAG) was performed, revealing a mild lesion in the left anterior descending (LAD) artery along with a myocardial bridge. The patient was managed with a combination of medications, including beta-blockers and antiplatelet therapy. However, due to persistent symptoms, the patient was ultimately advised to undergo coronary artery bypass surgery.

Conclusion: This case highlights the diagnostic challenges inherent in managing CAD, particularly among younger patients who present with atypical symptoms. The inconsistency between non-invasive test outcomes and the fluctuating nature of CAD symptoms underscores the importance of thorough and continuous clinical evaluations. Recognizing these complexities is crucial for enhancing patient outcomes and informing clinical decision-making in similar scenarios.

Terminalia chebula, a prominent herb in Ayurvedic medicine, has been traditionally used for its wide-ranging therapeutic benefits, including potential cardiovascular protection. This systematic review aims to evaluate the evidence supporting the cardioprotective effects of Terminalia chebula. A comprehensive search of electronic databases, including PubMed, Scopus, and Google Scholar, was conducted to identify relevant studies. Studies were selected based on criteria including study design, sample size, and outcome measures related to cardiovascular parameters. A total of X studies were included in this review. The findings suggest that Terminalia chebula exhibits significant cardioprotective effects, primarily through its antioxidant, anti-inflammatory, and lipid-lowering properties. Evidence indicates improvements in blood pressure, reduction in lipid levels, and modulation of oxidative stress markers. Despite promising results, the review highlights several limitations, including variability in study design, sample sizes, and methods of assessment. Further research is needed to confirm these effects, optimize therapeutic dosages, and explore the underlying mechanisms. This review provides a comprehensive overview of the current understanding of Terminalia chebula's role in cardiovascular health and identifies directions for future research to enhance clinical applications.

Background: PIH produces remote complications like cardiovascular diseases and also an independent predictor of peripheral arterial disease. Ankle-brachial index (ABI) is highly effective in diagnosing PAD. Aims and Objectives: 1. To estimate the risk of PAD among normal pregnant women and pregnant women with Hypertension in Pregnancy. 2. To determine the risk factors for development of PAD in these mothers. Methodology: Prospective cohort study consisting of 2 groups, Group 1: normal pregnant mothers with no added co-morbid risk and Group 2: primigravidae with pregnancy induced hypertension. 36 patients in each group who were followed after 5 years for evaluation of risk of PAD by estimating ABI. Results: Ankle Brachial Index (ABI) was calculated at five years, follow-up in both the exposed and non-exposed group. ABI <0.09 was considered as indicator of PAD. Four patients in exposed group and two patients in non-exposed group had ABI <0.09, with an odds ratio of 3.12. Conclusion: Women with Pregnancy induced hypertension are at higher risk for development of Peripheral artery disease

Background: Ageing is associated with cognitive and physical decline, necessitating effective interventions to enhance health outcomes in older adults. This study aimed to assess the impact of aerobic exercise (Group A) and resistance training (Group B) on cognitive function (Montreal Cognitive Assessment, MOCA) and physical function (Time Up and Go test, TUG) in adults aged 60 years and older.

Methods: A total of 30 participants were recruited via simple random sampling from Chennai, India. Group A engaged in aerobic exercise, while Group B performed resistance training. Pre- and post-intervention assessments of MOCA and TUG were conducted over 12 weeks.

Results: Significant improvements were observed in both cognitive and physical function in both groups. However, Group A showed a larger mean improvement in MOCA scores (mean increase of 4.5 points) compared to Group B (mean increase of 2.8 points). Similarly, for TUG scores, Group A demonstrated a greater improvement (mean decrease in time of 2.1 seconds) compared to Group B (mean decrease of 1.3 seconds).

Conclusion: Aerobic exercise yielded superior benefits in enhancing cognitive and physical function compared to resistance training in older adults. These findings highlight the importance of incorporating aerobic exercise into lifestyle interventions aimed at promoting healthy ageing.

BACKGROUND: Dengue is an epidemic throughout the world and with its new upswings which has caused an increased number of fatalities. In critical cases, increased serum ferritin has been observed to play a pathogenic role by enhancing the activity of immune cell producing a cytokine storm. AIMS & OBJECTIVE: The aim of the present study was to determine whether the serum ferritin, the biomarker of an acute phase reactant or not and to find out if serum ferritin levels can predict the severity of dengue early. METHODS AND MATERIALS: This was a single centre, prospective observational study done on 400 patients with positive NS1Ag or dengue antibody serology Ig-M and are admitted in Medicine ward or in MICU during study period from 2ndJanuary 2020 to 31stDecember 2022 (3 years), in tertiary care centre of Madhubani Medical College, Madhubani, Bihar. The enrolled patients underwent serum ferritin level analysis at time of admission. Serum ferritin levels were later compared with the severity of the dengue disease (According to WHO dengue classification 2009). RESULTS:   The mean serum ferritin levels were 289.47 ± 146.46ng/ml in DF without warning signs, 360 ± 228.48ng/ml in DF with warning signs, 1102.32 ± 423.54 ng/ml in severe dengue (p<0.05). Mean serum ferritin levels on day 1-3 was 289.40 ± 184.02ng/ml in DF without warning signs, 257 ± 83.18 ng/ml in DF with warning signs, 1047 ± 501.17 ng/ml in severe dengue (p<0.001). Mean serum ferritin levels on day 4-5 was 303.22 ± 96.47ng/ml in DF without warning signs, 378.61 ± 175.77 ng/ml in DF with warning signs, 1182 ± 432.14ng/ml in severe dengue (p<0.001).Mean Serum ferritin levels on day 6-7 was 234 ± 0ng/ml in DF without warning signs, 572.22 ± 427.44ng/ml in DF with warning signs, 1132 ± 417.70 ng/ml in severe dengue (p>0.05).   CONCLUSION: According to our study serum ferritin levels can be used as an early predictor of severity of dengue, especially with in first 5 days of onset of symptoms. A cut of > 422ng/ml had a sensitivity of 100% and specificity of 81.46% to differentiate between severe and non-severe dengue fever from our study.