@article{Haq_2025,

title = {A study of clinical profile, chest X-ray, ECG changes, and 2D echocardiography in patients with chronic cor pulmonale},

author = {Mohammed Zia ul Haq and Parvaiz Kadloor and Sayed Mohammed Hussain Bangi},

url = {https://ijcva.org/pdf/1fe4afca-adad-4137-be7c-36a5e5ab6910/articles/ijca.2025.73745/179-184.pdf},

doi = {10.4274/ijca.2025.73745},

issn = {2405-819X},

year  = {2025},

date = {2025-12-12},

urldate = {2025-12-12},

journal = {International Journal of the Cardiovascular Academy},

volume = {11},

issue = {4},

pages = {179-184},

abstract = {Background and Aim: Chronic obstructive pulmonary disease may result in chronic cor pulmonale, which is defined as right ventricular dilatation and/or hypertrophy resulting from pulmonary hypertension. A non-spesific clinical presentation and limited access to advanced diagnostic tools in resource-constrained settings make early diagnosis challenging. To evaluate the clinical profile and diagnostic findings from chest radiography, electrocardiography (ECG), and two-dimensional echocardiography in patients with clinically confirmed chronic cor pulmonale.

Materials and Methods: A retrospective observational study was conducted at a tertiary care center from October 2016 to September 2018. A total of 50 patients aged 30 to 80 years with clinically diagnosed chronic cor pulmonale were enrolled. Clinical symptoms, radiographic changes, ECG findings, pulmonary function tests (PFTs), and echocardiographic parameters were studied.

Results: The mean age of patients in our study was 51.7 years, with a male predominance (92%). The most common presenting features included breathlessness (100%), productive cough (100%), swelling of the feet (86%), and loss of appetite (92%). Chronic bronchitis with emphysema was the most frequent etiology, accounting for 58% of cases. Chest X-rays revealed chronic bronchitis with emphysema in 58% of patients, increased transverse cardiac diameter in 40% of patients, and a right descending pulmonary artery diameter greater than 16 mm in 62% of patients. ECG findings included right axis deviation (86%), P pulmonale (74%), low-voltage QRS complexes (52%), and arrhythmias (72%). Obstructive patterns were observed in 96% of PFTs. Echocardiography demonstrated dilation of the right ventricle and right atrium in all patients, right ventricular hypertrophy in 84% of patients, pulmonary hypertension in 90% of patients, and tricuspid regurgitation in 90% of patients. Moderate-to-severe pulmonary hypertension was observed in 74% of patients.

Conclusion: In the present study, chronic bronchitis with emphysema was the predominant cause of chronic cor pulmonale among middle-aged males. Multimodal assessment using clinical, radiographic, ECG, and echocardiographic findings enables early diagnosis. Echocardiography serves as a critical tool for evaluating right heart involvement and guiding timely intervention in chronic cor pulmonale.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fatima_2025h,

title = {Evaluation of emergency laparotomy for ileocaecal emergencies a clinicopathology, prognosis, and outcome based study},

author = {Arshiya Fatima and Zaid Mazhar Syed and Syed Mohammed Sajjad Husayni},

url = {https://jccpractice.com/article/evaluation-of-emergency-laparotomy-for-ileocaecal-emergencies-a-clinicopathology-prognosis-and-outcome-based-study-1712/},

doi = {10.61336/jccp/25-11-129},

issn = {2457-7200},

year  = {2025},

date = {2025-12-11},

urldate = {2025-12-11},

journal = {Journal of Contemporary Clinical Practice},

volume = {11},

issue = {11},

pages = {1034-1039},

abstract = {Background and Objectives: Ileocaecal emergencies, such as perforation, blockage, and inflammatory or viral diseases, continue to be prevalent causes of acute abdomen necessitating immediate laparotomy. These disorders are linked to considerable morbidity and mortality, particularly when diagnosis or management is postponed. The current study sought to assess the clinicopathological characteristics, surgical findings, postoperative complications, prognosis, and overall outcomes of patients receiving emergency laparotomy for ileocecal crises. Materials and Methods: Most of the 60 patients were men, and the age group with the most cases was 30 to 50 years old. 95% of the symptoms were stomach pain, followed by vomiting (72%) and stomach distension (60%). The most common causes of ileocaecal emergencies were ileal perforation (40%), typhoid perforation (25%), intestinal blockage (20%), and tuberculosis-related pathology (15%). Loop ileostomy, resection with anastomosis, and primary closure were some of the most common methods used. 35% of patients had complications after surgery, with infections at the surgery site being the most prevalent. Results: Among the 60 patients, the majority were males, with the highest incidence in the 30–50-year age group. The most common presenting symptoms were abdominal pain (95%), vomiting (72%), and abdominal distension (60%). The leading causes of ileocaecal emergencies were ileal perforation (40%), typhoid perforation (25%), intestinal obstruction (20%), and tuberculosis-related pathology (15%). Primary closure, resection with anastomosis, and loop ileostomy were the commonly performed procedures. Postoperative complications occurred in 35% of patients, with surgical site infection being the most frequent. The overall mortality rate was 10%, primarily associated with delayed presentation, septic shock, and extensive peritoneal contamination. Early surgical intervention significantly improved outcomes. Conclusion: Ileocaecal emergencies remain significant clinical issues necessitating rapid diagnosis and quick surgical intervention to mitigate morbidity and mortality. Early presentation, vigorous resuscitation, and suitable surgical interventions are crucial factors influencing positive outcomes. Improving perioperative care and making early referral systems stronger can make patients' chances of getting better even better.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Husayni_2025,

title = {Accuracy of pre-operative scoring in predicting difficulty level of laproscopic cholecystectomy},

author = {Syed Mohammed Sajjad Husayni and Arshiya Fatima and Zaid Mazhar Syed},

url = {https://jccpractice.com/article/accuracy-of-pre-operative-scoring-in-predicting-difficulty-level-of-laparoscopic-cholecystectomy--1706/},

doi = {10.61336/jccp/25-11-127},

issn = {2457-7200},

year  = {2025},

date = {2025-12-09},

urldate = {2025-12-09},

journal = {Journal of Contemporary Clinical Practice},

volume = {11},

issue = {11},

pages = {997-1008},

abstract = {Background: Difficult laparoscopic cholecystectomy (DLC) remains a major intraoperative challenge, especially in resource-limited settings where early identification of high-risk cases is crucial for minimizing bile duct injury, operative delays, and conversion to open procedures. Although several predictive systems exist, most are derived from mixed populations or rely on subjective parameters, limiting their applicability in newly developing laparoscopic units. Objective: To validate a preoperative scoring system for predicting difficult laparoscopic cholecystectomy and to establish a modified intraoperative grading score incorporating comprehensive operative parameters. Methods: A prospective cross-sectional study was conducted on 150 patients undergoing elective laparoscopic cholecystectomy for symptomatic cholelithiasis. Preoperative variables were scored using a modified predictor scale, while intraoperative difficulty was graded using an expanded objective score incorporating adhesions, gallbladder distension, BMI, prior surgical scarring, bile/stone spillage, ductal injury, conversion, and ligature method. Diagnostic performance was assessed using sensitivity, specificity, predictive values, and ROC analysis. Multivariate logistic regression identified independent predictors of difficult LC. Results: Based on intraoperative scoring, 28.7% of patients experienced moderate–severe difficulty. The preoperative score demonstrated excellent discriminatory ability (Sensitivity 94.8%, Specificity 96.2%, AUC 0.945). The intraoperative score also performed strongly (Sensitivity 95.8%, Specificity 98.1%, AUC 0.939). Independent predictors of difficult LC included age ≥50 years, history of acute cholecystitis, BMI >30, palpable gallbladder, impacted stone, adhesions burying the gallbladder, dissection time >90 min, bile/stone spillage, and suture ligature requirement. Conclusion: Both the preoperative and modified intraoperative scoring systems demonstrated high diagnostic accuracy and reliability for predicting difficult LC. These scoring tools are simple, objective, reproducible, and particularly valuable in resource-limited settings for optimizing surgical scheduling, assigning appropriate expertise, improving patient counseling, and reducing intraoperative complications. Implementation of these scores may enhance safety and standardize difficulty assessment across surgical teams.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Qamesa_2025,

title = {A comparative study of conservative and surgical intervention in the management of venous leg ulcer},

author = {Ubhatullah Qamesa and T. Naga Raja Ravi Kishore and Satya Srividya Kalluri},

url = {https://healthcare-bulletin.co.uk/article/a-comparative-study-of-conservative-and-surgical-intervention-in-the-management-of-venous-leg-ulcer-4488/},

doi = {10.61336/ejcm/25-11-34},

issn = {2042-4884},

year  = {2025},

date = {2025-11-15},

urldate = {2025-11-15},

journal = {European Journal of Cardiovascular Medicine},

volume = {15},

issue = {11},

pages = {229-235},

abstract = {Background:: Venous leg ulcers are chronic, recurring wounds of the lower limbs caused by venous hypertension and valvular incompetence. They represent a major cause of morbidity and impaired quality of life. Although conservative measures such as compression therapy and wound care promote healing, recurrence is common. Surgical correction of venous reflux may offer better long-term outcomes. This study aimed to compare conservative and surgical management in the treatment of venous leg ulcers with respect to healing rate, ulcer size reduction, and duration of recovery. Aim of the study was to evaluate and compare the efficacy of conservative and surgical management in venous ulcer healing, analyze changes in ulcer size at 1 and 2 months, and assess overall healing at 6 months. Materials and Methods: A prospective comparative study was conducted on 60 patients with venous leg ulcers, divided into two groups of 30 each. Group I (Conservative) received regular wound dressing, compression therapy, and sclerotherapy. Group II (Surgical) underwent ligation and stripping of incompetent veins or subfascial perforator ligation. Parameters such as ulcer size, duration, site, and healing status were recorded at baseline, 1 month, 2 months, and 6 months. Statistical analysis was done using unpaired t-test, Chi-square test, and ANOVA, with p < 0.05 considered significant. Results: The mean age was 58.4 ± 7.43 years in the conservative group and 56.1 ± 5.66 years in the surgical group. The medial malleolus was the most common ulcer site (82%). Mean ulcer size reduction was significantly greater in the surgical group (p < 0.0001). After two months, ulcer size decreased to 12.73 ± 2.85 mm in the surgical group and 27.73 ± 4.72 mm in the conservative group. Complete ulcer healing at six months was achieved in 90% of surgical patients and 63.3% of conservative patients (p = 0.0146). Conclusion: Surgical management provides faster and more complete healing compared to conservative methods. While conservative therapy is effective for symptom control, surgical correction of venous incompetence significantly improves healing outcomes and reduces recurrence, making it the preferred treatment modality},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Begum_2025b,

title = {Spontaneous pneumomediastinum in acute severe asthma: A case report},

author = { Syeda Tasneem Begum and Mohammed Abdul Basith and Asfa Durdana and Ashfaq Hasan and Mohammed Aleemuddin Naveed and Fahad Abdullah Bin Briek and Syed Mahmood Ahmed and Shireen Adeeb Mujtaba Ali},

url = {https://journals.lww.com/jdrntruhs/fulltext/2025/10000/spontaneous_pneumomediastinum_in_acute_severe.13.aspx},

doi = {10.4103/jdrntruhs.jdrntruhs_37_24},

issn = {2277-8632},

year  = {2025},

date = {2025-10-31},

urldate = {2025-10-01},

journal = {Journal of Dr. NTR University of Health Sciences},

volume = {14},

issue = {4},

pages = {434–437},

publisher = {Wolters Kluwer Health},

abstract = {Spontaneous pneumomediastinum (SPM), also known as mediastinal emphysema, develops as a consequence of acute severe asthma and is an uncommon entity. It is essential to recognize this complication since it must be distinguished from other potentially fatal illnesses. The purpose of presenting this case report is to highlight its importance, consider it in the differential diagnosis (d/d) of various problems resulting from acute severe asthma, and provide a detailed explanation of its management strategy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hadi_2025,

title = {Evaluation of body weight/body mass index as a predictor of dengue severity in children},

author = {Mohammad Abdul Hadi and Mehnaaz Sameera Arifuddin and Mohammed Abdul Hannan Hazari},

url = {https://amphysiol.com/index.php/amp/article/view/v8i1.00076/2025_7_13.pdf},

doi = {10.23921/amp.2025v8i1.00076},

issn = {2456-8422},

year  = {2025},

date = {2025-10-31},

urldate = {2025-10-31},

journal = {Annals of Medical Physiology},

volume = {8},

issue = {1},

pages = {7-13},

abstract = {Higher body mass index (BMI) is a risk factor for many non-communicable diseases and certain infectious diseases. Very less evidence is available that links body mass with dengue severity especially in children. The aim of this study was to evaluate any association between body weight/body mass index of children with severity of dengue illness. A retrospective, medical-records based observational study was conducted on 100 dengue-infected children in the age group of 2-15 years between August and October 2023. Dengue serology, complete blood picture, liver enzymes and coagulation profile were noted along with recording of anthropometric parameters like height and weight at the time of admission. Based on clinical presentation, patients were classified as severe and non-severe dengue. Most of the admitted dengue infected children belonged to underweight (67%) and normal weight (27%) category. The patients were divided into 2 groups: Group 1 included patients in the age group of 2-5 years where the independent variable considered was z-score for weight-for-age and Group 2 included patients between >5-15 years where z-score for BMI-for-age was taken as independent variable. Binomial logistic regression analysis was done to correctly classify the cases as non-severe and severe based on z-scores of weight-for-age / BMI-for-age (independent variable) of the effected children which was statistically significant in group 2 (p=0.000). The model correctly classified 61.8% of cases in group 1 and 86.4% of cases in group 2. Though the majority of cases were in underweight or normal weight category, the results indicate that those with higher weight and BMI for their age and gender are more likely to develop severe dengue infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kishore_2025,

title = {Revalidating preoperative prediction score and to develop a more accurate prediction score-to predict difficult cholecystectomy},

author = {T. Naga Raja Ravi Kishore and Ishrath Anjum and Zaid Mazhar Syed and Satya Srividya Kalluri and Syed Asif Shah Harooni},

url = {https://jccpractice.com/article/revalidating-preoperative-prediction-score-and-to-develop-a-more-accurate-prediction-score-to-predict-difficult-cholecystectomy-1502/},

doi = {10.61336/jccp/25-10-89},

issn = {2457-7200},

year  = {2025},

date = {2025-10-24},

urldate = {2025-10-24},

journal = {Journal of Contemporary Clinical Practice},

volume = {11},

issue = {10},

pages = {648-657},

abstract = {Background: Laparoscopic cholecystectomy is the gold standard for symptomatic gallstone disease due to its minimally invasive nature and faster recovery. However, intraoperative challenges can increase the risk of conversion and complications. Predicting surgical difficulty preoperatively enables better planning and patient safety. This study aimed to design and validate a scoring system to predict laparoscopic cholecystectomy difficulty using clinical and imaging parameters. Materials and Methods: A prospective study was conducted on 50 patients undergoing laparoscopic cholecystectomy at Princess Esra Hospital and Owaisi Hospital & Research Centre, Hyderabad, after obtaining ethical clearance. Clinical, biochemical, and imaging findings were analyzed, and scoring parameters were formulated to predict surgical difficulty. Results and Observations: Most patients were young adults (19–30 years) and female (76%), presenting predominantly with right hypochondrial pain and dyspeptic symptoms. Imaging revealed gallbladder wall thickening, CBD stones, and inflammatory changes in select cases. A scoring system comprising 21 preoperative and 13 intraoperative parameters was developed, stratifying patients into three risk categories: Very Low (0–6), Low to Moderate (7–14), and Moderate to High (15–30). Higher scores correlated with increased surgical difficulty and conversion rates. Conclusion: Laparoscopic cholecystectomy remains the safest and most effective treatment for gallbladder disease. The proposed scoring system provides a simple and reliable tool to predict operative difficulty, allowing for better surgical planning, appropriate allocation of resources, and improved patient outcomes},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kishore_2025b,

title = {A prospective study on independent risk factors for lower limb amputation in diabetic foot patients},

author = {T. Naga Raja Ravi Kishore and Satya Srividya Kalluri and Venugopal Sarveswaran},

url = {https://healthcare-bulletin.co.uk/article/a-prospective-study-on-independent-risk-factors-for-lower-limb-amputation-in-diabetic-foot-patients-4388/},

doi = {10.61336/ejcm/25-10-71},

issn = {2042-4884},

year  = {2025},

date = {2025-10-22},

urldate = {2025-10-22},

journal = {European Journal of Cardiovascular Medicine},

volume = {15},

issue = {10},

pages = {405-411},

abstract = {Background: Diabetic foot remains one of the most serious complications of diabetes mellitus, often leading to infection, ulceration, gangrene, and limb amputation. It reflects a complex interaction between neuropathy, ischemia, and infection. Early identification of risk factors is essential for prevention and limb preservation. Aim of the study was to identify and quantify the independent risk factors associated with lower limb amputation among patients with diabetic foot disease. Materials and Methods: This prospective descriptive analytic study was conducted at the Department of General Surgery, Sri Ramakrishna Hospital, Coimbatore, from November 2014 to November 2016. A total of 150 diabetic foot patients aged 18–80 years were included. Clinical evaluation, laboratory investigations, Doppler ultrasonography, and culture studies were performed. Variables such as age, sex, duration of diabetes, HbA1C level, peripheral vascular disease (PVD), neuropathy, smoking, foot deformities, and comorbid illnesses were analyzed. Statistical analysis was done using SPSS version 17.0, with p < 0.05 considered significant. Results: Among the 150 patients, 98 (65.3%) were males and 52 (34.7%) females, with the majority in the 51–60-year age group. Neuropathy was observed in 40%, and ischemia in 35.3% of patients. Overall, 74 patients (49.3%) required amputation—24 (16%) major and 50 (33.3%) minor—while 76 (50.7%) were managed conservatively. Foot infections were present in 68.6%, with Pseudomonas (15.3%) and Staphylococcus aureus (12.7%) being the most common pathogens. Univariate analysis revealed smoking, PVD, neuropathy, higher PEDIS grade (>3), and associated comorbidities as significant predictors of amputation (p < 0.05), whereas duration of diabetes, HbA1C level, previous amputation, and foot deformities were not statistically significant. Conclusion: Neuropathy, ischemia, and infection remain the principal determinants of amputation in diabetic foot disease. Smoking and systemic comorbidities further increase the risk. Early detection, strict glycemic control, proper foot care, and a multidisciplinary approach are essential to prevent limb loss and improve outcomes in diabetic patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ali_2025b,

title = {Rare meets routine: a case of sessile serrated lesion presenting as acute appendicitis},

author = {Syed Mubid Ali and Mohammed Abdullah Masood and Naushaba Tazeen and Asiya Tabassum and Idrees Akhtar Afroze and Atiya Begum and Shireen Adeeb Mujtaba Ali},

url = {https://ijpo.co.in/archive/volume/12/issue/3/article/24927/pdf},

doi = {10.18231/j.ijpo.11098.1680662831},

issn = {2394-6784},

year  = {2025},

date = {2025-10-17},

urldate = {2025-10-17},

journal = {Indian Journal of Pathology and Oncology},

volume = {12},

issue = {3},

pages = {279-282},

abstract = {Sessile serrated lesions (SSLs) are rare premalignant neoplasms usually arising in the colon but can also occur in the appendix, where their presentation often mimics acute appendicitis. We report the case of a 68‑year‑old male who presented with right lower abdominal pain and imaging findings suggestive of acute appendicitis with appendicular mucocele. The patient underwent appendectomy, and histopathological examination of the resected specimen revealed a sessile serrated lesion with marked dysplasia, without evidence of adenocarcinoma. Appendiceal SSLs are seldom reported in literature and may be overlooked due to their nonspecific clinical and radiological features. As SSLs are important precursors of colorectal carcinoma via the serrated neoplasia pathway, meticulous histopathological evaluation is crucial for accurate diagnosis. Early recognition, surgical excision, and colonoscopic follow‑up can help prevent malignant transformation. This case adds to the limited literature on appendiceal SSLs and emphasizes the need for increased awareness and documentation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Atharuddin_2025,

title = {A comparative study of wound healing and complications with the use of 1-0 vicryl vs 1-0 prolene for rectus closure},

author = {Athar Mohammed Atharuddin and Neda Faraz and Arshiya Fatima},

url = {https://jccpractice.com/article/a-comparative-study-of-wound-healing-and-complications-with-the-use-of-1-0-vicryl-vs-1-0-prolene-for-rectus-closure-1458/},

doi = {10.61336/jccp/25-10-55},

issn = {2457-7200},

year  = {2025},

date = {2025-10-15},

urldate = {2025-10-15},

journal = {Journal of Contemporary Clinical Practice},

volume = {11},

issue = {10},

pages = {372-380},

abstract = {Background: Surgery and sutures are inseparable. Down the ages, newer and more efficacious suture materials and techniques have been introduced. Among all wound closures, abdominal wound closure is the most challenging task for a surgeon. There are different techniques according to suture material, suturing technique and length of suture material that have been suggested optimal for rectus closure. These prospects are still under study and are controversial. This study was to compare the efficacy of vicryl and prolene for rectus closure by studying the wound healing and complication rates (wound infection, wound dehiscence, burst abdomen etc). Materials and Methods: The present prospective comparative study was conducted on patients admitted for surgeries in the Department of General surgery, Deccan College Of Medical Sciences, Hyderabad. for a period of 18 months. Prior to the initiation of the study, Ethical and Research Committee clearance was obtained from Institutional Ethical Committee. During present study total 50 patients meeting inclusion criteria were enrolled into the study. Results and observations: There was no statistical difference between the groups in terms of age (p: 0.1358); gender (p: 1.131); diabetic status (p: 1.1532); BMI (p: 1.1611); type of surgery (p: 0.8321); duration of surgery (p: 0.8321); intra operative hypotension prevalence (p: 0.1352); type of incisions (p: 1.3521); type of surgical site infections (p: 0.06). The incidence of burst abdomen (p: 0.01) was high in group B, day of burst abdomen incidence (p: 0.02), incidence of surgical site infections high in group B (p: 0.01); rate of wound healing was slow in group B (p: 0.001) Conclusion: From the present study we conclude that non-absorbable suture (prolene) was better in terms of wound healing and cosmesis as compared to absorbable suture used (vicryl) taking into consideration the points: wound dehiscence, burst abdomen incidence, surgical site infections incidence was higher in group B comparatively. Group B subjects had a slower rate of wound healing comparatively.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ayesha_2025c,

title = {Assessment of hearing impairment in patients with allergic rhinitis through audiological profile},

author = {Syeda Ayesha and Waseem Ahmed and Khurram Adil Hashmi},

url = {https://www.ijmedph.org/Uploads/Volume15Issue3/391.%203001.%20IJMEDPH_Shubham%20Jaju_2118-2121.pdf},

doi = {10.70034/ijmedph.2025.3.391 },

issn = {2230-8598},

year  = {2025},

date = {2025-09-30},

urldate = {2025-09-30},

journal = {International Journal of Medicine and Public Health},

volume = {15},

issue = {3},

pages = {2118-2121},

abstract = {Background: Allergic rhinitis (AR) is a common chronic inflammatory disorder affecting the upper respiratory tract, which may also impair auditory function through Eustachian tube dysfunction and middle ear involvement. Despite increasing awareness, its impact on hearing remains under-recognized. To assess the audiological profile of patients with allergic rhinitis using tympanometry and pure tone audiometry, and to explore the correlation between hearing thresholds and duration of AR symptoms.

Materials and Methods: This cross-sectional, hospital-based study included 150 patients with clinically diagnosed allergic rhinitis and 150 age-matched controls. Audiological evaluation was conducted using the Titan Interacoustic Tympanometer and standard pure tone audiometry. Tympanogram types, air conduction thresholds, and degrees of hearing loss were compared. Pearson correlation was used to analyze the relationship between symptom duration and hearing thresholds. 

Results: AR patients had significantly more abnormal tympanograms (Type B: 20.7%, Type C: 10%) compared to controls (Type B: 3.3%, Type C: 4.7%) (p < 0.001). Air conduction thresholds were elevated across all frequencies in the AR group (p < 0.001), with a mean threshold of 30.5 ± 8.2 dB at 8000 Hz. Hearing loss was detected in 32% of AR patients—predominantly mild (22.7%) and moderate (6.7%). A moderate positive correlation (r = 0.41, p < 0.001) was found between duration of AR and hearing loss severity.

Conclusion: Allergic rhinitis is significantly associated with subclinical conductive hearing loss and abnormal middle ear function, which worsen with prolonged symptom duration. Early audiological screening in AR patients is essential to prevent long-term auditory complications.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Idris_2025,

title = {Eustachian valve endocarditis in patients with fournier’s gangrene and septic shock: a rare case and a literature review },

author = {Ahmed Sifeeldein Ahmed Idris and Umme Nashrah and Umme Amara and Nissar Shaikh},

url = {https://www.qscience.com/docserver/fulltext/qmj/2025/3/qmj.2025.93.pdf?expires=1759819401&id=id&accname=guest&checksum=1C92FB251CA567B82A4BCC00C75DACF1},

doi = {10.5339/qmj.2025.93},

issn = {0253-8253},

year  = {2025},

date = {2025-09-15},

urldate = {2025-09-15},

journal = {Qatar Medical Journal},

volume = {2025},

issue = {3},

pages = {93},

abstract = {Introduction: The eustachian valve (EV) is a remnant of the right sinus venosus valve. It remains different in size and shape without much impact on adult life. In 5% to 10% of all endocarditis, are seen in the right side of the heart is involved, which is rare compared to the left side of the heart. Bacteremia, central venous catheter, heart implants, and drug abuse increase the risk of EV vegetation and right heart endocarditis. We are reporting a case of EV endocarditis in patients with Fournier’s gangrene and septic shock. Case Presentation: A 45-year-old male patient was admitted into the surgical intensive care unit with Fournier’s gangrene, septic shock, and acute kidney injury (AKI). The patient was managed by invasive ventilation, noradrenaline, vasopressin, and renal replacement therapy. He developed Escherichia coli bacteremia and candidemia. We added meropenem and antifungal to the therapy. The transthoracic echocardiography showed EV vegetation and thread-like vegetation in the right coronary sinus, which was confirmed with transesophageal echocardiography. With aggressive therapies, the patient recovered from septic shock, organ dysfunction and was successfully liberated from invasive ventilation. The patient was discharged home on day 27. The antibiotics and antifungal were continued for 6 weeks. Two weeks after discharge, the follow-up echocardiogram was normal, and he was doing well. Discussion: Eustachian valve endocarditis is rare, and should be treated with appropriate, culture- and sensitivity-guided antibiotics and or antifungal therapy for 6 weeks. The outcome of EV vegetations of endocarditis is good. The reported mortality is up to 17%. The independent risk factors associated with mortality are AKI, the Charlson comorbidity index, congestive heart failure, larger vegetation, and central nervous system involvement. Conclusion: The presence of larger EV, along with E. coli (ESBL) bacteremia and fungemia, increases the risk of right-sided endocarditis, which is rarely reported. Our patient was diagnosed early, received appropriate antimicrobial treatment for a sufficient duration, resulting in a better outcome. A high index of suspicion, along with early diagnosis and culture-guided 6-week antimicrobial therapy, will improve the patient’s outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fatima_2025e,

title = {Humoral immune response to COVID-19 vaccine in health care workers and the factors influencing it during vaccine drive - a cross-sectional study},

author = {Sarwat Fatima and Deepika Handa},

url = {https://ijmmtd.org/archive/volume/11/issue/3/article/24512/pdf},

doi = {10.18231/j.ijmmtd.v.11.i.3.15 },

issn = {2581-4753},

year  = {2025},

date = {2025-09-04},

urldate = {2025-09-04},

journal = {IP International Journal of Medical Microbiology and Tropical Diseases},

volume = {11},

issue = {3},

pages = {323-329},

abstract = {Background: The COVID-19 vaccine drive by the public healthcare system had several safety and efficacy concerns in the minds of health care workers and common man for several vague reasons.

Objective: In this context; the study was planned to determine the humoral immune response in the vaccine recipients of the first indigenously prepared vaccines in India [Covaxin & Covishield]. And, to know the influence of various factors on it. Lastly, to note the adverse events reported by the recipients if any.

Materials and Methods: A cross-sectional point prevalence study with simple convenient sampling method was designed. Baseline data on demographics, presence of comorbid conditions, vaccination details, adverse events to vaccine and information on presence of COVID-19 disease in the past 3-6 months was obtained from participants using a validated questionnaire. Institutional ethical clearance was obtained. The participants’ inclusion and exclusion criteria were established. SARS-CoV-2 IgG antibody was determined using ELFA method. Antibody index was estimated and used for interpretation of the test results. Statistical R software was used for data analysis.

Results: of the 86 participants, 84 were found eligible for enrollment. Male to female ratio was 0.9:1. The study participants were in the age group from 20-80 years. Around 29/84[34.52%] had comorbid conditions and the commonest comorbid conditions was hypertension. Overall, 72/84 [86%] of the HCWs were seropositive following vaccination. Greater number of fully vaccinated HCWs 60/62 [97%] were seropositive than partially vaccinated 12/22 [54%] with a p value of 0.001 and their corresponding antibody index was also higher. Among the various variables studied age, gender and presence of comorbid conditions the last one had a positive impact on seropositivity and antibody index values. Mild adverse events following vaccination were noted in majority. However, the antibody index was higher for them than in participants with no adverse events.

Conclusion: Our study highlights the efficacy and safety of vaccine by demonstrating seroconversion in 86% of the recipients and clears the vaccine hesitancy from the minds of HCWs and common man as well.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Singhal_2025,

title = {A narrative review on fecal microbiota transplantation routes in ulcerative colitis: identifying the optimal approach across key parameters},

author = {Rohan Singhal and Gayatri Ghadvaje and Nanditha Karra and Sai Teja Gadde and Prerna Chandra and Bharat Krishna Teja Voruganti and Navya Pillikunte Doddareddy and Sadaf Iftikhar and Tirath Patel},

url = {https://journals.lww.com/annals-of-medicine-and-surgery/abstract/9900/a_narrative_review_on_fecal_microbiota.3380.aspx},

doi = {10.1097/ms9.0000000000003841},

issn = {2049-0801},

year  = {2025},

date = {2025-09-02},

urldate = {2025-09-02},

journal = {Annals of Medicine & Surgery},

abstract = {Fecal microbiota transplantation (FMT) has gained increasing attention as a novel therapeutic approach for treating ulcerative colitis (UC), a chronic inflammatory bowel disease that causes an imbalance in the gut microbiota. Although FMT has demonstrated the potential to induce remission in UC patients, the most effective route of administration remains an area of active investigation. This narrative review provides a comprehensive comparison of different FMT delivery methods, such as oral capsules, enemas, colonoscopy, and nasogastric or nasoenteric tubes, across a range of clinically relevant parameters, including efficacy, safety, patient satisfaction, microbiota changes, pretreatment protocols, and cost-effectiveness. Furthermore, we examined how post-FMT dietary interventions may influence microbial engraftment and improve the long-term outcomes in patients with UC. In addition to assessing these practical and clinical factors, this review highlights the importance of patient-centered considerations, such as the tolerability and convenience of each administration route. The integration of these findings can provide valuable insights into how different FMT routes affect disease outcomes and guide clinicians in optimizing the treatment for individual patients. By synthesizing current evidence on these key variables, we aimed to identify the most effective and feasible FMT approach for UC. Establishing standardized protocols for FMT administration, informed by this analysis, will be crucial for ensuring consistency in clinical practice, improving patient outcomes, and minimizing adverse events. The insights from this review will help pave the way for more targeted and individualized FMT strategies, ultimately enhancing the therapeutic landscape of UC management.},

note = {Ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Chaudhry_2025,

title = {Fetal-maternal complications due to pregnancy-acquired tuberculosis: a narrative review of the literature},

author = {Waleed Razzaq Chaudhry and Sana Altaf and Cara Mohammed and Sofia Fuerte},

url = {https://www.monaldi-archives.org/macd/article/view/3126/2125},

doi = {10.4081/monaldi.2025.3126},

issn = {1122-0643},

year  = {2025},

date = {2025-09-01},

urldate = {2025-09-01},

journal = {Monaldi Archives for Chest Disease},

abstract = {Tuberculosis (TB) during pregnancy can cause certain deleterious effects to both the mother and the fetus, leading to significant morbidity and mortality. The risk of TB rises significantly during pregnancy due to dampening of the immune response in females and certain factors yet to be studied. Since pregnant females are ruled out of clinical trials due to their pregnancy status, not much clinical data is available on how to combat TB in them or about the clinical safety and efficacy of certain drugs. Hence, not only is it important to make pregnant females vital study participants of clinical trials, but also to enhance their knowledge regarding the disease so that they may timely access quality care. It is also important to facilitate these TB-positive pregnant females through the introduction of gender-sensitive policies that are more exclusive and allow access to quality TB control programs that provide timely care, nutritional support, and quality and supportive management.},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hazari_2025,

title = {Correlation of comorbidities and outcome in CAD patients: a novel TANGENTS score study},

author = {Mohammed Abdul Hannan Hazari and Kailas Laxman Rao and Bachi Tazneem and Sana Rafeeq and Syeda Rahmath Fatima and Summaya Jabeen and Kankan Kavya},

url = {https://mmsl.cz/artkey/mms-202503-0002_correlation-of-comorbidities-and-outcome-in-cad-patients-a-novel-tangents-score-study.php},

doi = {10.31482/mmsl.2024.009},

issn = {0372-7025},

year  = {2025},

date = {2025-09-01},

urldate = {2024-06-18},

journal = {Military Medical Science Letters},

volume = {94},

issue = {3},

pages = {107-114},

publisher = {Faculty of Military Health Sciences, University of Defence, Czech Republic},

abstract = {Background: Cardiovascular diseases (CVD) are influenced by various established risk factors, including the ratio of neutrophils to lymphocytes and platelets, which has been shown to be an independent risk factor for acute coronary syndrome (ACS). This study aims to create a new scoring system called TANGENTS that utilizes discrete parameters of risk factors and diagnostic parameters to analyze the outcome of coronary artery disease (CAD) patients with comorbidities, particularly Type 2 diabetes mellitus (T2DM).

Methods: We included 151 subjects (mean age 57.92 ± 23.86) who presented with ST-elevation and ST-depression on admission and were treated with heparin, clopidogrel, aspirin, and atorvastatin while undergoing all the necessary diagnostic tests. We obtained ECG and complete blood picture (CBP) results on admission, day 3, and day of discharge.

Results: ST-depression on ECG on day-1 was 0.35 and decreased to 0.30 on the day of discharge. ST-elevation on ECG on day-1 was -0.89 and decreased to -0.16 on the day of discharge. The average neutrophil-to-lymphocyte ratio (NPR) was 0.49, which was high in 144 patients. The mean NLR value was 5.52, indicating a correlation between high NLR values and the magnitude of current injury on admission.

Conclusion: The TANGENTS scoring system can be used as an early evaluation tool for CAD patients with comorbidities to manage and prevent further complications. It allows for progressive differentiation in the severity of clinical outcomes using all the parameters of the score, and the parameters creating the TANGENTS score scale were found to be reliable.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025h,

title = {Anticoagulant initiation after cardioembolic stroke: practical timing and options},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/14185/8653},

doi = {10.18203/2394-6040.ijcmph20252872},

issn = {2394-6032},

year  = {2025},

date = {2025-08-30},

urldate = {2025-08-30},

journal = {International Journal of Community Medicine and Public Health},

volume = {12},

issue = {9},

pages = {4186-4195},

abstract = {Cardioembolic Stroke (CES) is a leading cause of Acute Ischemic Stroke (AIS) and is linked to worse outcomes. There is a notably increased risk of “hemorrhagic transformation” (HT) in CES cases, where anticoagulant therapy is essential for patients with atrial fibrillation (AF) to prevent future strokes. Additionally, larger infarcts are associated with a higher risk of HT, effectively doubling the mortality risk. Currently, there are no clear guidelines connecting infarct size to “anticoagulation” decisions or management of HT cases. This review specifically focuses on the timing of “anticoagulation” initiation in patients with AF. Out of 380 articles evaluated, 50 relevant studies were included in this review. Generally, existing guidelines recommend starting “anticoagulation” between 4 to 14 days after anAIS. The review seeks to summarize current research on early versus late “anticoagulation” initiation in AF patients who experience AIS, providing clinicians with practical insights on optimal timing and the selection of effective and safe anticoagulants.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Faraz_2025,

title = {Role of c-reactive protein, serum amylase and apache II scoring system in predicting the severity of acute pancreatitis},

author = {Neda Faraz and Mohammed Abdul Hadi and Ameer Khan},

url = {https://jccpractice.com/article/role-of-c-reactive-protein-serum-amylase-and-apache-ii-scoring-system-in-predicting-the-severity-of-acute-pancreatitis-1219/},

doi = {10.61336/jccp/25-08-102 },

issn = {2457-7200},

year  = {2025},

date = {2025-08-25},

urldate = {2025-08-25},

journal = {Journal of Contemporary Clinical Practice},

volume = {11},

issue = {8},

pages = {761-766},

abstract = {Background: Acute pancreatitis is a catastrophic condition with many complications and poses a great challenge to the treating surgeon. 1020% of the patients who develop complications will not recover with simple supportive therapy. Hence, an accurate prediction of severity and prognostic monitoring are necessary to anticipate the early and late complications so as to consider aggressive treatment. The present study aimed at predicting the prognosis in patients with acute pancreatitis by using the serum AMYLASE, serum LIPASE, APACHE II scoring system and at determining the utility of these scores in further management. Methods and Material: 84 patients, who were admitted to the PES Institute of Medical sciences with the clinical and radiological evidence of acute pancreatitis with an elevation in the serum amylase levels, were the subjects of this study. Results: Among 84 patients, 50 had severe disease and 34 had mild disease based on serum CRP (P<0.05).On the first day of hospitalisation Serum amylase and APACHE II scoring system were analysed. Serum CRP taken at 48 hours of admission. The age of incidence is often between 31 to 40 years. Males are more commonly affected than females. Alcohol was the main factor in both mild and severe disease-related deaths. The upper limit in this study for serum amylase were 1000U/L, APACHE II score >8 and serum CRP >150mg/L. The percentile of patients for mild and severe pancreatitis for serum amylase, APACHE II score and serum CRP includes 83.3%, 45.2%, 40.5% and 16.7%, 54.8%, 59.5%. The standard deviation of serum amylase, APACHE II score and serum CRP includes 347.1,3.0, 24.1.The statistical inference of all the three parameters comparing one value with other parameters shows serum CRP has significant value of P<0.05. Conclusion: Serum CRP plays a significant role in stratifying individuals for early, aggressive treatment in order to reduce morbidity and mortality from acute pancreatitis. To define characteristics that allow for the establishment of multifactorial scores or biomarkers to predict acute pancreatitis severity and track disease progression, large population-based multi centre studies must be designed and conducted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tague_2025,

title = {Exploring the national burden and challenges in the fight against yellow fever in the Democratic Republic of Congo. A review},

author = {Christian Tague and Mayar Moustafa Budair and Maher Ali Rusho and Areeba Aamir Ali Basaria and Rabeea Tariq and Hermann Yokolo and Joshua Ekouo and Farheen Naaz and Dujardin Makeda and Adolphe Karegeya and Mc Juan Muco Mugisha and Calvin R. Wei},

url = {https://journals.lww.com/annals-of-medicine-and-surgery/abstract/9900/exploring_the_national_burden_and_challenges_in.3295.aspx},

doi = {10.1097/ms9.0000000000003730},

issn = {2049-0801},

year  = {2025},

date = {2025-08-19},

urldate = {2025-08-19},

journal = { Annals of Medicine & Surgery},

abstract = {The Democratic Republic of Congo (DR Congo) is facing a public health emergency due to numerous infectious diseases, predominately yellow fever. Since 2015, numerous outbreaks of the illness have occurred in the country which resulted in detrimental impacts on the population. As of February 2024, the DR Congo has reported over 1,200 suspected yellow fever cases with an 11% case fatality rate. This represents a 22% increase compared to 2021 when 203 confirmed cases were reported with a 9% fatality rate. Although there is no specific medication to treat yellow fever, vaccination is proven to be the most effective method of prevention. Despite national and international efforts to combat the disease through vaccination campaigns, yellow fever continues to pose a significant threat. This is because vaccination efforts are limited by the inadequate infrastructure, poverty, poor sanitation and the presence of rebel groups in the DR Congo. Early diagnosis, the use of mosquito nets and insecticides, as well as raising awareness can furthermore aid in limiting transmission. This review explores the prevalence, diagnosis and prevention methods of yellow fever in the DR Congo, as well as the numerous obstacles faced by the country to eliminate it.},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Alali_2025,

title = {From air embolism to acute respiratory distress syndrome: a rare complication in a posterior fossa tumour excision-a case report},

author = {Jawdat M. Alali and Umme Amara and Umme Nashrah and Firdous E. Ummunnisa and Mahmoud Tabouni and Nissar M. Shaikh },

url = {https://www.sciencedirect.com/science/article/pii/S2210261225010223?via%3Dihub},

doi = {10.1016/j.ijscr.2025.111836},

issn = {2210-2612},

year  = {2025},

date = {2025-08-18},

urldate = {2025-08-18},

journal = {International Journal of Surgery Case Reports},

volume = {135},

pages = {111836},

abstract = {No abstract available},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Naaz_2025,

title = {Prognostic value of plasma lysophosphatidic acid and CD62P in the outcome of ischemic stroke },

author = {Sabeeha Naaz and Swarna Anupama and Thrilok Chander Bingi},

url = {https://journals.lww.com/annalsofian/abstract/9900/prognostic_value_of_plasma_lysophosphatidic_acid.453.aspx},

doi = {10.4103/aian.aian_83_25},

year  = {2025},

date = {2025-08-13},

urldate = {2025-08-13},

journal = {Annals of Indian Academy of Neurology},

number = {pmid40802465},

pages = {1-6},

abstract = {Background and objectives: Stroke is the second leading cause of death worldwide, and only 10% of the patients can live their normal lives. As per the Global Burden of Disease Study 2016, the incidence of stroke in India is reported to be 1,175,778 (1 076 048 to 1,274,427) per 100000 person-years. A novel biochemical marker that can predict the stroke outcome can reduce morbidity, especially when thrombolysis cannot be done. Hence, the current study aims to study the role of plasma lysophosphatidic acid (LPA) and CD62P as prognostic markers for acute ischemic stroke.

Methods: This is a prospective observational study. Ninety-six patients who met the inclusion criteria were enrolled. The plasma LPA and CD62P levels were estimated using the enzyme-linked immunosorbent assay and correlated with the Alberta stroke program early computed tomography score (ASPECTS) on CT brain and modified Rankin scale (mRS) at 90 days.

Results: Age, sex, and other risk factors in the ischemic stroke patients did not have any impact on the levels of LPA and CD62P. Both LPA (P = 0.000) and CD62P (P = 0.005) showed a positive correlation with mRS after 90 days. The mean LPA was highest for mRS 5 and least for mRS 1, whereas the mean CD62P levels did not correlate with increasing mRS. The ASPECTS showed a significant negative correlation only with LPA.

Conclusions: High LPS and CD62P levels after stroke onset tend to be associated with poor mRS scores at 90 days.},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Begum_2025,

title = {A comprehensive review on orthopedic pain},

author = {Syeda Zuleqaunnisa Begum and Saritha Chukka and Mohammed Akram},

url = {https://www.rjptonline.org/HTMLPaper.aspx?Journal=Research%20Journal%20of%20Pharmacy%20and%20Technology;PID=2025-18-8-69},

doi = {10.52711/0974-360X.2025.00566},

issn = {0974-360X},

year  = {2025},

date = {2025-08-02},

urldate = {2025-08-02},

journal = {Research Journal of Pharmacy and Technology},

volume = {18},

issue = {8},

pages = {3939-3944},

abstract = {Orthopedic pain management is complex and challenging in healthcare due to its characteristics, causes and frequency of recovery. Nociceptive and Neuropathic pain pathway are the underlying mechanism involved with numerous symptoms aching, stiffness, burning sensations, pain worsening with movement, severe bruising, inflammation, cramping, localized tenderness. Unidimensional scale, multidimensional scale and postoperative pain measurement techniques are used to assess the appropriate pain intensity and relief. Pharmacological management involves a combination of non-opioid analgesics, opioids, adjuvant agents, and emerging therapies, with a focus on multimodal analgesia to enhance pain relief and minimize opioid use. The review also highlights challenges in managing orthopedic pain, including diagnostic complexity, imaging limitations, the need for individualized treatment plans and psychological and social factors. Pain should be considered during preoperative, intraoperative, postoperative and at the time of discharge. Effective pain management requires constant reassessment with individualized treatment regimen. Major efforts should be taken by the healthcare professional and patients during the postoperative pain period as it involves the healing period associated with several risk factors like hospital discharge, severity of surgery, physiotherapy mobilization. Implementation of multimodal pain management along with physiotherapy, exercise and patients counselling are effective for reducing postoperative pain.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ali_2025d,

title = {A review delving through current challenges in AMR and using artificial intelligence in dealing with AMR},

author = {Shireen Adeeb Mujtaba Ali},

url = {https://journals.lww.com/sbvj/fulltext/2025/07000/a_review_delving_through_current_challenges_in_amr.12.aspx},

doi = {10.4103/sbvj.sbvj_39_25},

issn = {2581-6039},

year  = {2025},

date = {2025-07-31},

urldate = {2025-07-01},

journal = {SBV Journal of Basic, Clinical and Applied Health Science},

volume = {8},

issue = {3},

pages = {155–158},

publisher = {Wolters Kluwer Health},

abstract = {Antimicrobial resistance in pathogenic microorganisms is being accelerated by the overuse of antibiotics, which is a major global public health concern. Severe infections, serious complications, longer hospital stays, and even higher death rates are all brought on by increasing resistance. National economies and health systems are greatly impacted by antimicrobial resistant (AMR), which reduces patient or caregiver productivity by causing extended hospital stays that are expensive. While conventional methods of addressing antimicrobial resistance (AMR) are costly and time-consuming, artificial intelligence (AI) is currently being developed to quickly search through large chemical libraries and predict potential antibacterial compounds. Using AI, scientists may quickly find possible new medications that might work against germs resistant to antibiotics, which might save a significant amount of time throughout the development process. AI algorithms that analyse enormous volumes of data can also assist in forecasting future patterns in antibiotic resistance, enabling preventative actions. In the continuous fight against antibiotic resistance, the use of AI in medical research appears to have a lot of promise. In addition to discussing AMR, this review explains how AI is being used in AMR markers to help manage AMR.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Moinuddin_2025,

title = {Unexplained hypoglycemia in a diabetic patient unveiling insulinoma: a case report},

author = {Mohammed Faris Razi Moinuddin and Aasiya Shahbaz Sakarwala and Noor Ul Ain Shahzad and Waleed Ahmad},

url = {https://innovapath.us/index.php/IN/article/view/74/63},

doi = {10.63501/7xvwd239},

issn = {3067-8102},

year  = {2025},

date = {2025-07-31},

urldate = {2025-07-31},

journal = {INNOVAPATH:Journal of Translational Medicine & Biotechnology},

volume = {1},

issue = {6},

pages = {5},

abstract = {Background: Insulinomas are rare, typically benign, insulin-secreting neuroendocrine tumors with an incidence of 1–4 cases per million annually. They commonly present with Whipple’s triad: symptoms of hypoglycemia, low plasma glucose, and resolution of symptoms with glucose administration. The coexistence of insulinoma with type 2 diabetes mellitus (T2DM) is extremely uncommon and often results in diagnostic delays due to overlapping clinical features and misattribution of hypoglycemia to antidiabetic therapy. Case Presentation: We describe the case of a 65-year-old obese woman with a 16-year history of T2DM and hypertension, who presented with persistent symptomatic hypoglycemia despite discontinuation of insulin therapy. Her HbA1c ranged between 5.7% and 8.4% over the past year, and she was previously managed with 40 units/day of premixed insulin. Hypoglycemic episodes continued after insulin cessation, prompting inpatient evaluation. During hospitalization, she exhibited documented plasma glucose of 33 mg/dL with concurrent inappropriately elevated insulin (74.4 µIU/mL) and C-peptide (8.5 ng/mL) levels, confirming endogenous hyperinsulinemia. Chromogranin A was markedly elevated (350 ng/mL). Imaging via contrast-enhanced CT revealed a 14-mm hypervascular lesion in the pancreatic tail. The patient underwent successful laparoscopic distal pancreatectomy. Histopathology confirmed a 17-mm, well-differentiated, grade 3 pancreatic neuroendocrine tumor, positive for chromogranin and synaptophysin. Postoperatively, she developed persistent hyperglycemia requiring resumption of premixed insulin at 0.6 U/kg/day. At 3-month follow-up, she remained insulin-dependent but was free of further hypoglycemic episodes. Discussion: This case underscores the diagnostic complexity when insulinoma coexists with long-standing T2DM. In patients with continued hypoglycemia after insulin withdrawal, endogenous causes such as insulinoma must be considered. High clinical suspicion, biochemical profiling during hypoglycemic episodes, and timely imaging are essential. Notably, this case involved a well-differentiated grade 3 tumor; an uncommon histological finding in insulinomas which may have implications for surveillance due to its potential for more aggressive behavior. The persistence of diabetes post-resection highlights the ongoing insulin resistance associated with long-standing T2DM, despite tumor removal. Conclusion: Insulinoma should remain a differential in diabetic patients presenting with unexplained or worsening hypoglycemia, particularly after insulin discontinuation. Early diagnosis, appropriate imaging, and surgical resection are crucial for favorable outcomes. Postoperative metabolic monitoring remains essential due to the dual risk of hyperglycemia and hypoglycemia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Quadri_2025,

title = {Menstrual health practices in women with severe psychiatric disorders},

author = {Syeda Kulsoom Quadri and Mohammed Abdur Rahman and Mariyah Amjad and Zohra Fatima S. and Syed Shah Ali Hussain Razvi and Mohd. Amrullah and Syeda Ayesha Siddiqua},

url = {https://www.msjonline.org/index.php/ijrms/article/view/15094/9775},

doi = {10.18203/2320-6012.ijrms20252388},

issn = {2320-6012},

year  = {2025},

date = {2025-07-30},

urldate = {2025-07-30},

journal = {International Journal of Research in Medical Sciences},

volume = {13},

issue = {8},

pages = {3228-3232},

abstract = {Background: Menstrual hygiene constitutes an essential facet of women's health and dignity. Women diagnosed with severe mental illness frequently encounter obstacles in the maintenance of personal hygiene attributable to cognitive impairments, deficits in self-awareness and reliance on caregivers. Notwithstanding its critical importance, menstrual hygiene continues to be an overlooked dimension of mental health care for this demographic. To assess and compare menstrual hygiene practices among females with severe mental illness and healthy age-matched caregivers using the Menstrual Practice Needs Scale (MPNS-36). Methods: This cross-sectional, comparative study was conducted at the Department of Psychiatry at Shadan Institute of Medical Sciences, Telangana. A total of 80 participants were recruited through consecutive sampling 40 clinically stable female patients diagnosed with schizophrenia, bipolar affective disorder or obsessive-compulsive disorder and 40 healthy female caregivers as controls. Sociodemographic and clinical details were collected using structured proformas. Menstrual hygiene practices were assessed using the MPNS-36. Data were analyzed using SPSS (22.0) and a p value of <0.05* was considered statistically significant. Results: The mean age of patients and caregivers was 34.59±5.09 years and 31.14±6.33 years, respectively. Statistically significant differences were observed in domains related to comfort with menstrual materials, adequacy of supplies and worry about running out of materials. Other domains showed no significant intergroup differences. Conclusions: Women diagnosed with severe mental illnesses exhibited both equivalent and inadequate menstrual hygiene practices in comparison to healthy control subjects. The incorporation of menstrual hygiene education within psychiatric rehabilitation programs is imperative for fostering comprehensive care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}