An official publication of Gujarat Adani Institute of Medical Sciences Published by: Gujarat Adani Institute of Medical Sciences G K General Hospital Opposite Lotus Colony Bhuj, Kachchh, Gujarat – 370001
Gujarat Adani Institute of Medical Sciences
A Study of the Influence and Effectiveness of an Innovative Gharana Mentorship House System on Undergraduate Medical Students
Background: Mentorship is an important educational strategy to foster academic success, personal wellbeing and professional development in undergraduate medical students. As group mentoring holds immense potential in medical education, the Gharana Mentorship House System, inspired by house mentorship models in schools, was implemented for the first time at Gujarat Adani Institute of Medical Sciences (GAIMS), Bhuj, India, to enhance mentorship for undergraduate students. Aim: To evaluate the effectiveness of a new concept of Gharana mentorship house system program for undergraduate students at GAIMS, Bhuj. Objectives: a) To assess the perception of mentees and mentors about the program. B) To assess academic performance and attendance of students to measure effectiveness of Gharana Program. C) To identify the strengths and challenges of this mentorship program Material and Methods: A cross-sectional study was conducted at GAIMS where the Gharana Mentorship House system was introduced. Data was collected from volunteer mentors and mentees using validated semi structured Google questionnaires containing both open and closed ended questions. Attendance records and marks obtained in exams were procured from academic records Results: 230 mentees and 30 mentors volunteered to participate in the study. Quantitative analysis revealed statistically significant association in improvement of students’ attendance and academic performance (p < 0.0001). Quantitative analysis of perception of both mentors and mentees was positive. Mentees expressed that this program had provided them with both professional and personal support. Most mentors agreed that the program was running as planned, there was no additional burden on them, and that they were motivated to volunteer for future mentoring. Qualitative themes highlighted the challenges, valuable insights and experiences of mentors from the mentor mentee relationship Conclusion: The Gharana Mentorship House System is an innovative and effective model of mentorship which combines traditional values with modern concepts to enhance mentorship quality and student outcomes in undergraduate medical education.
Copyright (c) 2025 Devika Bhat https://creativecommons.org/licenses/by-nc-sa/4.0
Understanding Cervical Cancer Prevention and Practice of Human Papillomavirus Vaccination: A Study Among Medical Students of Ahmedabad
Background: Early HPV vaccination can significantly reduce the burden of cervical cancer, yet most of India’s population remains unprotected. Medical students, as future healthcare advocates, are key to improving HPV vaccination through their awareness and practice. This study aims to assess the socio-demographic profile of participants, measure their awareness about cervical cancer and its prevention, vaccination status, and to correlate these findings with socio-demographic details. Material and Methods: A cross sectional study was conducted among 181 medical students of Ahmedabad using a standardized, validated questionnaire consisting of open ended, Yes/No/Don’t know and MCQ questions. Statistical analysis was performed and appropriate tests were applied. Results: The study included 128 females (70.7%) and 53 males (29.3% ) with a mean age of 19.85 ± 1.60 years. While 82.3% identified cervical cancer as a leading cause of death among women, only 56.9% were aware that HPV affects both genders. Although 77.3% were aware of the HPV vaccine, correct knowledge about the recommended age group and dose schedule was low (14.9% and 5.5%respectively). Only 43 students (23.75%) were vaccinated with significantly more females being vaccinated (z = 2.5297, p = 0.0114). Among unvaccinated participants, the major barriers to HPV vaccination included lack of knowledge (31.15%), limited access to vaccine (10%), and lack of motivation (6.52%). Conclusion: Although awareness about HPV infection and cervical cancer among medical students is good, there is a lack of awareness and knowledge about prevention of cervical cancer. Practice of HPV vaccination among medical students was found to be low.
Copyright (c) 2026 Richa Gupta, Sheetal Shrimali https://creativecommons.org/licenses/by-nc-sa/4.0
Decoding the Triglyceride/HDL-C Ratio: A Marker for Type-2 Diabetes Risk
Background: Diabetes mellitus (DM) is the most common endocrine disorder worldwide. Beyond the established markers of glycemic control and insulin resistance (IR), there remains a need for reliable, accessible, and reproducible indicators. To address this, our study evaluated the triglyceride to HDL cholesterol ratio (THR) as a potential marker for insulin resistance and glycemic regulation. Materials and methods: We retrospectively analyzed TG, fasting serum glucose (FSG), and fasting insulin levels from 953 samples processed between March and August 2024. Based on homeostasis model assessment-estimated insulin resistance (HOMA-IR) values, patients were categorized into two groups: good versus poor glycemic control. The discriminatory power of the triglyceride-to-HDL cholesterol ratio (THR) for differentiating these groups was evaluated using Receiver operating characteristic (ROC) analysis, with statistical significance set at p<0.05. Furthermore, multivariate logistic regression analysis was performed. Results: The mean age of participants was 40.83 ± 16.78 years. Significant differences (p<0.001) were observed between patients with good and poor glycemic control in gender, FSG, HOMA-IR, FI, TG, and THR, but not in age (p=0.613). Pairwise correlation showed THR had a moderate negative correlation with HDL (r=-0.555, p<0.001) and a strong positive correlation with TG (r=0.959, p<0.001). With a cutoff value of ≥2.64, THR demonstrated high selectivity and positive predictive value (PPV) (AUC=0.72; Se=65%; Sp=70%; p<0.001; 95% CI: 0.66–0.78). Men were 2.247 times more likely than women to exhibit poor glycemic control (p=0.022). The risk of poor control increased by 1.045-fold with age and 1.056-fold with glucose (p=0.007). Conclusion: Based on our findings, the THR appears to be a promising marker for assessing glycemic control and insulin resistance.
Copyright (c) 2025 Asha Gupta, Dinesh Kumar Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Distribution of ABO and Rhesus (Rh) Blood Groups among Voluntary Donors in Kachchh Gujarat
Background: The ABO and Rh blood group systems are the most important blood group systems in Transfusion Medicine. This study was carried out with an objective to study the distribution of ABO and Rh blood groups among voluntary blood donors in Western Gujarat, India which is essential for effective management of blood inventory. Material and methods: The present retrospective study was carried out at GKGH Blood centre. The data of present study is from 01/01/2024 TO 31/12/2024. Total 19355 voluntary blood donors were considered medically fit and accepted for blood donation. ABO and Rh typing were done by Complete Grouping Card method by Tulip matrix, both forward and reverse blood grouping after validation at blood centre. Results: Out of 11,013 blood donors O blood group was most common (3520-31.96%) and the least blood group was AB Blood group (70-0.63%). There were more Rh-Positive blood donors as compared to Rh Negative blood donors. Conclusion: The most common blood group among voluntary donors was O positive and least common blood group was AB negative.
Copyright (c) 2025 Saniyah Godar, Suman Khoja https://creativecommons.org/licenses/by-nc-sa/4.0
The Influence of Magnesium on Blood Glucose Control
Background: Magnesium acts as a cofactor in glucose phosphorylation and numerous other enzymatic reactions. Its deficiency may contribute to insulin resistance, carbohydrate intolerance, and dyslipidemia. Reduced serum magnesium levels have been linked to the development of diabetic complications, including retinopathy, altered platelet function, cardiovascular disease, and hypertension. The present study aimed to examine the association between serum magnesium levels and glucose regulation. Materials and methods: Data from 256 patients who underwent serum testing for glucose, magnesium, glycated hemoglobin (HbA1c), insulin, and lipid profile between May 2024 and June 2025 were retrospectively analyzed. Based on glucose and HbA1c values defined by the 2017 American Diabetes Association guidelines, participants were categorized into three groups: non-diabetic, prediabetic, and diabetic. Intergroup comparisons were conducted using the Kruskal–Wallis H test and the Mann–Whitney U test. Results: Among the participants, 137 were nondiabetic, 85 were prediabetic, and 34 were diabetic, with median ages (range) of 40 years (24–55), 45 years (35–58), and 48 years (30–57), respectively. Magnesium levels differed significantly between the nondiabetic and diabetic groups, as well as between the prediabetic and diabetic groups (both p<0.001). However, no significant difference was observed between the nondiabetic and prediabetic groups. Patients with insulin resistance (HOMA-IR ≥2.5) had significantly lower magnesium levels (p=0.020). Furthermore, serum magnesium showed a significant negative correlation with glucose (r=–0.244, p<0.001), HbA1c (r=–0.332, p<0.001), and HOMA-IR values (r=–0.162, p=0.010). Conclusion: Magnesium serves as a cofactor for several enzymes involved in carbohydrate oxidation and is essential for glucose transport across the cell membrane. This study found that reduced magnesium levels adversely influenced glucose regulation. Incorporating magnesium-rich foods or providing oral magnesium supplementation may help improve insulin sensitivity in diabetic patients with low serum magnesium.
Copyright (c) 2025 Kiran R Bagale, Dinesh Kumar Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence, Clinical Profile and Outcome Predictors in Very Low Birth Weight and Extremely Low Birth Weight Neonates in Tertiary Care Hospital
Background: Neonates with very low birth weight (VLBW) and extremely low birth weight (ELBW) has a much higher chance of experiencing serious health complications or even death. Their results depend on a myriad of newborn and maternal variables. Thus, it is important to assess and treat them specifically. Objective: The goals of this study are to quantify and assess the clinical profile, and to identify factors that are predictive of adverse outcomes of VLBW and ELBW neonates. Methods: This prospective observational research was conducted in the tertiary level neonatal intensive care unit (NICU) from 2022 to 2024. Of the 88 newborns enrolled, information gathered include factors such as birth weight, gestational age, gender, family medical history, prenatal treatment, delivery specifics, clinical trajectory and outcomes. Neonates were treated according to standard treatment guidelines. Results: There was a frequency of 1.10% for VLBW and 0.18% for ELBW. Thrombocytopenia, respiratory distress syndrome, and sepsis were among the most common complications. Results improved when antenatal steroids were used and when ANC visits were sufficient. Comparing ELBW and VLBW infants, the mortality rate was greater in the former (52.94% vs. 23.94%). Low gestational age, pulmonary hemorrhage, DIC, thrombocytopenia, and the requirement for ventilatory support were major indicators of poor prognosis. Conclusion: Neonates born with very low birth weight (VLBW) or extremely low birth weight (ELBW) are at increased risk and should receive intensive prenatal care, the early detection of maternal risk factors, and specialized newborn care. Neonatal intensive care units need to identify factors that can lead to a bad result so that they can allocate resources more wisely and intervene quickly.
VLBW, ELBW, Neonatal Morbidity, Neonatal Mortality, NICU, Gestational Age, ANC, Sepsis, RDS, Neonatal Outcomes
Copyright (c) 2025 Mukundkumar Vaja, Janvi Soni, Dipika Bhil, Jaishree Parmar, Maitri Joshi, Saloni Shah https://creativecommons.org/licenses/by-nc-sa/4.0
Correlation of Gestational Age Assessed by Last Menstrual Period, Antenatal Ultrasonography and New Ballard Score
Background: Determining gestational age (GA) significantly influences the prognosis of newborns. Of the various methods available for gestational age assessment, gestational age assessment by first trimester ultrasonography (USG) as the most reliable method gestational and by LMP (last menstrual period), is next best surrogate. In remote areas and rural settings in Low and Middle Income Countries, the reliability of LMP based GA assessment is questionable due to low literacy rates and less awareness among women and USG is not cost effective. In such a scenario, GA assessment by clinical methods like New Ballard Score (NBS) seems an attractive alternative. Hence this study was conducted to compare the reliability of GA assessments by LMP and NBS as compared to 1st trimester ultrasonography in our institute. Methods: This was a prospective study carried out at neonatal intensive care unit of a tertiary care teaching hospital of western Gujarat, India, from August 2022 to July 2023. A total of 200 neonates with mother having first trimester scan and who recalls LMP were recruited for the study. Gestational age according to first trimester scan was calculated and compared with gestational age according to LMP and NBS. Results: Gestational age by UGS with NBS show significant correlation (p value <0.001) Gestational age by LMP with NBS show significant correlation (p value <0.001) Significant correlation was also observed between gestational age accessed by LMP, first trimester USG and NBS (p value <0.001) Gestational age by UGS with NBS which gave a higher correlation (r = 0.886), Correlation among all three gestational age by LMP, USG and NBS which came out to be lower than previous (r =0.545) and at last Correlation amongst gestational age according to LMP and NBS came out to be lowest (r =0.540). Hence, gestational age by USG comes out to be most similar with gestational age by NBS. Conclusions: In low resource settings and in public sector hospitals, GA assessment by NBS is a more reliable option than LMP, and it closely correlates with GA assessed by USG.
Copyright (c) 2025 Maitri Chauhan, Yashvi Dattani, Sandeep Tilwani, Vinisha Makhijani, Shivani Barad, Rekha Thaddanee https://creativecommons.org/licenses/by-nc-sa/4.0
An Observational Cross-sectional Study to Assess Awareness of Personal Hygiene and Food Safety among Food Handlers In and Nearby Area of Tertiary Care Hospital
Background: Food hygiene and food safety are also major issues worldwide, particularly in developing countries such as India. Significant changes in food production, handling and preparation methods, as well as in the habits of food-eating among people, have made food unsafe. Food handlers are the main contributors to food-borne outbreaks, and food establishments are the main sources of food-borne disease. So, this study assess awareness of personal hygiene and food safety among food handlers in and nearby area of tertiary care hospital. Material and methods: This was an observational analytical cross-sectional study. The study was carried out in surrounding area near tertiary care hospital of Bhuj city and study duration was 3 months. Sample size:193. Results: 36 out of 43 (41.86%) central canteen - mess food handlers, 30 out of 48 (34.88 %) of the restaurants food handlers and 20 out of 98 (23.26%) mobile food handlers had good knowledge of food safety. This study identifies significant gaps in food safety and personal hygiene knowledge among food handlers, particularly among mobile food handlers. Mobile handlers lagged behind in critical hygiene areas such as handwashing, medical check-ups, and food handling practices. Socio-demographic and occupational factors such as younger age, higher education, longer working hours, and possession of food licenses were positively associated with better food safety knowledge.
Copyright (c) 2025 Pralhad Potdar S, Onkar Gaikwad, Jay Joshi, Shraddha A Katariya, Milankumar V Golakiya, Densi M Kakadiya, Bhartiben Kavad, Neel A Patel, Raju D Kodiyatar, Vatsalkumar P Rathod, Sachinkumar Sangada, Vikrambhai G Suthar https://creativecommons.org/licenses/by-nc-sa/4.0
United Against Venom: India's 'One Health' Blueprint for Snakebite Prevention
India's recently launched National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE) marks a pivotal moment in critical fight against snakebites.
Copyright (c) 2025 Mandar Chandrachood https://creativecommons.org/licenses/by-nc-sa/4.0
Turn Around Time (TAT): The Critical Link Between Laboratory Testing and Patient Outcome
Background: Turnaround time (TAT) in a clinical biochemistry laboratory refers to the total time taken from when a test is ordered to when the result is reported back to the clinician. The study aims to evaluate the TAT time of the clinical biochemistry lab, assessing the pre-analytical and post-analytical phases' relative contributions to the TAT in comparison to the analytical phase and determining the quantity of samples reported outside the specified TAT. A number of actions that could shorten the turnaround time overall were also assessed. Materials and methods: The study was conducted at GKGH Hospital, Kachchh, a district hospital, to evaluate the turnaround time (TAT) on samples analyzed in the clinical Biochemistry laboratory. In the present study, TAT was evaluated for parameters such as RFT (Renal Function Test), SGPT (Serum glutamate Pyruvate transaminase), Electrolytes, Troponin, and ABG (Arterial Blood Gas analyzer). The samples were collected from the OPD and IPD. The clinical Biochemistry is equipped with Vitros DTS 5600 and 7600, a dry test-based auto-analyzer. Results: In the present study, the mean and SD were observed in case of RFT TAT was 78 ±41, SGPT TAT was 103±54, Troponin TAT was 78±33, ABG test TAT was 15±12, Electrolytes TAT was 76 ± 42. Conclusion: In the present study, Evaluation of TAT of basic emergency parameters, which are common tests done in the laboratory. We noticed the major cause of delayed TAT time is pre-analytic steps. By improving the phlebotomy procedure, sample transport flow, and sample preparation steps, the TAT time can be improved significantly.
Copyright (c) 2025 Darshan Patel, Dinesh Sharma https://creativecommons.org/licenses/by-nc-sa/4.0
Cytology’s New Frontier: The Sydney System’s Innovative Approach to Lymph Node Diagnosis
Background: FNAC is the first diagnostic step in patients with lymphadenopathy because of its simplicity and minimal invasive nature which helps to confirm the clinical suspicion. A definite specific diagnosis may not be possible in a few cases but a categorization of disease and differential diagnosis can help suggest the most efficient further investigations, saving time and resources. The aim of this study was to ascertain the system’s applicability and precision in the diagnosis of lymph node cytology. Material and methods: A retrospective cross-sectional study on lymph node cytology samples collected between January 2024 and June 2024, categorizing results into five groups (L1-L5) according to the Sydney System. Cytological findings were validated against histopathological results and relevant clinical data that prompted FNA procedures. Diagnostic performance was evaluated using metrics such as sensitivity, specificity, predictive values, and malignancy risk estimates. Results: 60 cases were evaluated by FNAC. Out of this 44 were benign cases, 16 cases were of Reactive lymphadenitis, 24 cases of Granulomatous/Tuberculous lymphadenitis and 4 cases were of Acute suppurative lymphadenitis. Out of 16 malignant cases, 1 case was of Non Hodgkins lymphoma, 2 case was of Hodgkins lymphoma and 13 cases were of metastatic carcinoma. Conclusion: The Sydney system was used for clinicopathological diagnosis of patients presenting with lymphadenopathy and was found to be a reliable tool for evaluation of risk of malignancy and its subsequent management of the patient.
Copyright (c) 2025 Nidhi Choudhari, Meghashree V, Vidhya Subramaniam, Sudha M, Prajna K S https://creativecommons.org/licenses/by-nc-sa/4.0
Region and Rabies: A Review of Geographical Variations, Challenges and Strategies for Control
Rabies, one of the oldest known zoonotic diseases, continues to claim thousands of lives every year—despite being entirely preventable. It disproportionately affects populations in Asia and Africa, particularly in low-resource rural regions where dog-mediated transmission remains endemic. This review explores the interplay between regional contexts and rabies epidemiology, highlighting disparities in disease burden, surveillance capacity, vaccine access, health infrastructure, and cultural beliefs. It also outlines successful regional interventions, emphasizing the need for geographically tailored strategies. With the global “Zero by 30” goal in sight, addressing these regional dynamics is key to achieving equitable and sustainable rabies elimination.
Copyright (c) 2025 Bharti Koria https://creativecommons.org/licenses/by-nc-sa/4.0
A Comparative Study of Orthogonal Versus Parallel Plating for Distal Humeral Fractures
Introduction: Fractures of the distal humerus are relatively common injuries, distal humerus fractures lead to significant burden on society due to its bimodal distribution with a peak in young males due to high energy trauma (road traffic accidents, fall from height, trauma to arm and gunshot wounds) and a other peak in older females usually by simple falls. There are several methods of fixation available, namely- plate fixation and external fixation. Out of which very commonly performed is plating. Material and Methods: A total of 40 patients distal humerus fractures were treated with dual plating between May 2022 and May 2024. Of these, 20 patients underwent orthogonal plating (Group A), while 20 patients were treated with parallel plating (Group B). Patients were selected based on specific inclusion criteria: age between 18-60 years, fractures of the distal humerus with intra condylar extension, closed fractures, non-compliant patients for conservative treatment, polytrauma patients, and those who refused conservative treatment. Exclusion criteria included patients younger than 18 or older than 60 years, fractures involving the shaft of the humerus, previous humeral surgery, pathological fractures, open fractures, and nerve palsy. This prospective study utilized a sample size of 40 patients, with Group A consisting of odd-numbered patients receiving orthogonal plating and Group B consisting of even-numbered patients receiving parallel plating. Results: Out of 20 operated cases of orthogonal plating, 18 patients had excellent, 2 patients had poor ASES score, whereas in parallel plating group 16 patients had excellent, 2 patients good, 2 patients poor American Shoulder and Elbow Surgeons (ASES) score, no post operative infections were noted, no non-union cases were noted, no significant difference in surgery time, blood loss, mean duration of hospital stay was noted. Conclusion: Both orthogonal plating and parallel plating had similar outcomes with respect to elbow function and early physiotherapy. No significant difference in surgery time, blood loss, mean duration of hospital stay were noted.
Copyright (c) 2025 Durga Prasad H N, Amit Sehgal, Chavi Sethi, Charu Thakur https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Language Barrier on Academic Performance of First Year Undergraduate Medical Students in Jamnagar
Background: Language proficiency plays a foundational role in the success of medical students, especially in multilingual countries like India, where students often come from diverse linguistic backgrounds. The transition from vernacular language-based schooling to English-medium medical education creates a significant challenge for first-year MBBS students. These students often struggle with understanding medical terminology, lectures and textbooks, all of which are primarily in English. This language barrier can impede their academic performance, communication skills and confidence, which are critical to becoming competent healthcare professionals. Objectives: This study aimed to assess the extent to which language barriers affect the academic performance of first-year MBBS students. Materials and Methods: This is an institution based cross-sectional study. Total 220 students participated in the study. A preformed questionnaire was given to the students. Result was obtained by the answers given by the students. Results: A total of 220 participants responded to the survey, including 118 (53.6%) males and 102 (46.4%) females. 160 (72.7%) of the total participants had studied in Gujarati medium, 16 (7.3%) of the total participants had studied in Hindi medium, while 44 (20%) of the total participants had studied in English medium. The majority 140 (63.7%) of the participants stated that they frequently used dictionaries for their studies and 80 (36.3%) did not use dictionaries. The results indicated that most participants, more specifically 110 (50%) medical students were neither comfortable nor uncomfortable (Neutral) with the English language, followed by 74 (33.6%) who were comfortable as opposed to 36 (16.4%) who were very uncomfortable. Conclusion: English Language Proficiency Program (ELPP) can be used at a level of medical colleges to increase the interest and academic performance of the students.
Copyright (c) 2025 Nileshwari Vala, I S Thianeswar, Kajal Gauswami https://creativecommons.org/licenses/by-nc-sa/4.0
Fibroepithelial Polyp in the Buccal Mucosa of a Libyan Patient: Case Report and Literature Review
Fibroepithelial polyp is one of the benign lesions of oral cavity which occurs as inflammatory response to local irritation or trauma. Clinically, patients with fibroepithelial polyps present as a painless pedunculated or sessile swelling. They can be treated by simple surgical excision or by other methods such as electrocautery or laser ablation. This is case report of a 48-year-old female who reported to the dental clinic with a soft to firm, painless pedunculated swelling in the left buccal mucosa. This patient underwent an excisional biopsy under local anesthesia. Histological examination confirmed the diagnosis of fibroepithelial polyp. In conclusion, fibroepithelial polyp should be kept as one of the differential diagnoses of benign soft tissue lesions of the oral cavity.
Copyright (c) 2025 Eman.A.B Aguori https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of Complete Immunization Coverage and Effect of Migratory Factors on Immunization Coverage of Children Residing at Construction Sites in Rajkot City, Gujarat
Background: Immunization is one of the most effective public health interventions, yet children of migrant construction workers often remain under-immunized due to unique socio-demographic and logistical barriers. This study aimed to evaluate complete immunization coverage and examine the effect of migratory factors on immunization among children residing at construction sites in Rajkot city, Gujarat. Material and methods: A cross-sectional study was conducted in 2019 in the field practice area of a community medicine department under Rajkot Municipal Corporation. A total of 244 children residing at construction sites were surveyed using a semi-structured questionnaire. Data on sociodemographic, immunization status, and migration history were collected and analyzed using appropriate statistical tests. Results: Full immunization coverage among the study population was 39.75%, while complete immunization coverage was 30.33%. Zero-dose prevalence was 12.7%. A statistically significant association was observed between immunization coverage and factors such as gender (p=0.00), birth order (p=0.00), and number of migrations (p=0.00), while place of migration showed no significant effect (p=0.23). The most common barriers to immunization were parental unawareness about vaccination sites (33.20%) and schedules (23.77%), followed by fear of wage loss due to post-vaccination illness (19.67%). Conclusions: Children of migrant construction workers in Rajkot city have considerably lower immunization coverage compared to district and national averages. Strengthening mobile outreach, increasing parental awareness, flexible session timings, and introducing incentives to offset wage loss could significantly improve immunization uptake among this vulnerable population.
Copyright (c) 2025 Kshama Gajera, Harsha Solanki, Nilesh Fichadiya, Bhargav Dave https://creativecommons.org/licenses/by-nc-sa/4.0
A Single-Center Case Series of Hereditary Ataxia from Gujarat: Clinical and Genetic Data
Background: Hereditary or genetic ataxia is a group of neurodegenerative conditions, characterized by progressive imbalance and ataxia, with convergent clinical profiles. Limited data on the prevalence and subtypes are available from Gujarat due to a lack of an ataxia registry or studies. Objective: To study clinical and genetic characteristics in patients with hereditary ataxia from Gujarat state. Material and Methods: This prospective observational study included and evaluated chronic cerebellar ataxia patients with suspected hereditary etiology. Based on the clinical findings, molecular analysis was performed using PCR-based trinucleotide repeat analysis for a single specific genotype, a selected panel, or a broader whole-exome sequencing method. Results: We identified 65 patients with possible genetic ataxia over 2 years. Forty-nine patients from this subgroup underwent genetic testing and obtained positive results in 29 patients. Spinocerebellar ataxia (SCA) type 2 was the most common type (31%) of Autosomal Dominant ataxia, and Friedreich’s ataxia (FA) was the most common Autosomal Recessive ataxia (13.8%). SCA patients had onset in the 2nd decade onwards and had strong positive family history, while FA patients had onset in the 1st decade. Clinical features were overlapping and nonspecific for the subtype of ataxia. Apart from incoordination, the most common clinical findings were eye signs, pyramidal tract involvement and peripheral neuropathy. Conclusion: Our Gujarat state cohort of hereditary ataxia resembles genotypic and clinical characteristic data from other studies in western India. We noted clinical phenotypic overlap in all subtypes of hereditary ataxia, which calls for molecular genetic testing for diagnosis.
Copyright (c) 2025 Pranav Joshi, Shalin Shah, Mukesh Sumra, Sudhir Shah https://creativecommons.org/licenses/by-nc-sa/4.0
Pseudoangiomatous Stromal Hyperplasia in an Unmarried Female with Asymmetric Breasts
Pseudoangiomatous stromal hyperplasia (PASH) is a non-cancerous mesenchymal growth in the breast. It was first described by Vuitch, et al. in 1986 wherein it appeared as a palpable breast lump in a patient. Only around 109 cases had been documented by 2008. The etiology and pathogenesis of PASH are still unknown; however, there is some evidence suggesting PASH is hormone dependent. Herewith we present a case of 29 years old unmarried lady who presented to plastic surgery department of our hospital with complaint of painless, asymmetric breasts. Her mammography showed global dense asymmetrical breast parenchyma more in left breast compared to her right breast. Her PASH diagnosis was confirmed on gold standard test of histopathology.
Copyright (c) 2025 Bhushan M Warpe, Shweta S Joshi, Pooja P Pandey, Sai K Manchikalapudi https://creativecommons.org/licenses/by-nc-sa/4.0
Capillary and Cavernous (Mixed) Type of Cervical Hemangioma with Uterine Adenomyosis in a 40-year-old Female
Hemangioma of the uterine cervix is an extremely rare benign vascular lesion and only a few sporadic cases have been reported. Cervical hemangioma is characterized by increase in the number of normal and abnormal veins. Histopathology examination is needed to diagnose hemangioma and to differentiate this disease with other pathological conditions. Hemangioma is a benign tumor which originates from endothelial cells of the blood vessels, which represent multipotent cellular elements, or from pericytes located on the outer side of the blood vessel wall. The majority of cervical hemangiomas have been reported in women of child bearing age.
Copyright (c) 2025 Shweta S Joshi, Bhushan M Warpe, Prachi S Patil, Bhumi Karodiya, Bhumika M Siddhpara https://creativecommons.org/licenses/by-nc-sa/4.0
A Prescription Audit Utilizing the World Health Organization Recommended Key Medication Use Indicators at a Tertiary Care Hospital, India
Background: Inappropriate drug usage is a global health issue, particularly in developing nations like India. Irrational drug use has a negative impact on both health and medical expenses. Prescription auditing is a crucial method for raising the standard of prescriptions, which raises the standard of care provided. The current study was conducted to evaluate the rational use of pharmaceuticals for completeness, readability, and against the key drug use indicators specified by the World Health Organization (WHO). Material and methods: In the surgery department, 300 prescriptions were chosen at random from the medical records for a cross-sectional retrospective analysis, regardless of the patient's diagnosis or characteristics. The WHO core drug use indicators, medical components, and general information were assessed for each prescription. Using Microsoft Excel, the collected data were tallied and shown as descriptive statistics. SPSS version 25 was used for analysis. Results: General information is included with every prescription. 67 percent of prescriptions were written under a generic name, while 85.6% of prescriptions included the diagnosis. On average, 11.45 prescription drugs were written. In 53.8% of prescriptions, the clinical examination was mentioned; however, in 94% of prescriptions, the history of allergy was not included. Conclusion: According to WHO-recommended parameters for quality improvement, our study emphasises the necessity of providing our prescribing physicians with detailed prescription writing training.
Copyright (c) 2025 Shruti Singh, Nirav Nimavat, Diyesh Gohel, Nishi Sinha, Rajesh Kumar, Sunil Kumar Singh, Divya Harsha https://creativecommons.org/licenses/by-nc-sa/4.0
Clinico-Epidemiological Profile and Study of Influenza and Their Subtypes Among Suspected Influenza Patients in a Tertiary Care Teaching Hospital of Vadodara
Background: Influenza viruses cause significant respiratory illness, with seasonal epidemics and occasional pandemics influenced by antigenic variation. Monitoring local prevalence and subtype distribution is vital for guiding public health responses. Material and methods: A descriptive cross-sectional study was conducted from March to December 2024. A total of 601 throat or nasopharyngeal swabs from suspected influenza cases were collected and tested using the PathoDetect™ multiplex real-time RT-PCR kit, which detects influenza A, B, and subtypes A(H1N1) and A(H3N2). Quality control included internal and external validation. Results: Overall positivity was 20.46%. The highest number of cases occurred in individuals >60 years, while the highest positivity rate was in children <10 years. Fever (78.86%) was the most common symptom; COPD (29.26%) was the leading comorbidity. Influenza A was predominant (92.97%), with H1N1 (53.90%) as the leading subtype, followed by H3N2 (8.59%). Two seasonal Peaks of H1N1 were observed in March–April and August–October. Five co-infections were detected: two with H1N1 and H3N2, and three involving Influenza B co-infected with H1N1, H3N2, and Untypable Influenza A. Conclusion: H1N1 is the dominant circulating strain. Findings highlight the need for continuous surveillance, timely diagnosis, and targeted vaccination. Broader community-based studies are recommended for comprehensive influenza control.
Influenza, H1N1, H3N2, Untypable Influenza
Copyright (c) 2025 Gulshan Chaudhary, Jigna Karia, Yash Khandelwal https://creativecommons.org/licenses/by-nc-sa/4.0
Clinico-histopathological Correlation in Ectopic Pregnancy: Insights from a Rural Tertiary Center in Maharashtra, India
Background: Derived from the Greek word ektopus, meaning "out of place," ectopic pregnancy entails the implantation of conceptus in any site other than a normal uterine location.[1] It remains a formidable challenge in women's healthcare, posing risks to both maternal life [2] and future fertility with global incidence ranging from 1-2%,[3] with approximately 3.12 per 1000 pregnancies in India. This study endeavors to conduct a comprehensive analysis of ectopic pregnancy cases, underscoring the pivotal role of histopathological examination in not only confirming the diagnosis but also unraveling the underlying etiologies. By integrating clinical findings with pathology, we aim to improve diagnostic accuracy, enabling timely interventions, fertility preservation, and better patient outcomes. Material and methods: A retrospective analysis was conducted on 120 cases of ectopic pregnancy diagnosed between January 2021 and January 2024 at the Department of Pathology, Swami Ramanand Teerth Rural Government Medical College, Ambajogai. Clinical data, including age, parity, gestational age, and risk factors, were collected. Histopathological specimens were processed and examined using Hematoxylin and Eosin (H&E) staining, with detailed observations recorded and analyzed. Results: The incidence of ectopic pregnancy was 1.13% of all gynecological cases, with the majority (70.83%) of patients in the 21-30 years age group. Multigravidity was common, with 47.12% presenting during their second pregnancy. The fallopian tube was the most frequent implantation site (97.29%), and rupture occurred in 57.65% of cases. Histopathological findings included chronic salpingitis (56.48%), salpingitis isthmica nodosa (9.2%), and acute salpingitis (4.6%). Additionally, 16.66% of cases were classified as normal. Conclusion: Histopathological examination is essential for the accurate diagnosis and management of ectopic pregnancies, particularly in atypical cases. The integration of clinical and pathological data enhances diagnostic precision, aids in identifying complications, and informs future fertility management. This study highlights the importance of clinicopathological correlation in ensuring optimal patient care and outcomes in ectopic pregnancy cases.
Copyright (c) 2025 Purva O Bhalerao, Dnyaneshwar S Jadhav, Sheela L Gaikwad, Arvind N Bagate https://creativecommons.org/licenses/by-nc-sa/4.0
Morbidity Patterns Among the Geriatric Population in Field Practice Area of a Tertiary Care Teaching Hospital in Ahmedabad: A Cross-sectional Study
Objective India is witnessing a demographic transition with the elderly population (≥ 60 years) projected to rise to 19% by 2050. This shift is associated with increased multimorbidity and a dual burden of communicable and non-communicable diseases, posing significant public health challenges. In this context, the present study aimed to assess the prevalence and pattern of self-reported morbidities among the elderly, identify common health conditions, and examine their association with socio-demographic factors in the field practice area of B.J. Medical College, Ahmedabad. Materials and Methods A cross-sectional study was carried out from August 2021 to August 2022 among 700 elderly individuals (≥60 years) attending health camps in five urban field practice areas. Data were collected using a pre-tested structured proforma through personal interviews, including socio-demographic profile, morbidity history, and age-related health conditions. Anthropometric measurements were also taken. Analysis was performed using descriptive statistics, chi-square test, Fisher’s exact test, and z-test, with significance set at p < 0.05. Results Of the 700 participants (mean age 72.1±5.4 years), 70.7% reported at least one morbidity. Hypertension (53.4%) and diabetes (25.1%) were the leading chronic conditions, while visual problems (62.4%), oral issues (45.0%), and joint pain (38.7%) were the most frequent age-related conditions. Females had significantly higher prevalence of hypertension (60.4%) and visual problems, whereas males had higher ischemic heart disease (6.1%) and asthma (10.2%). The 60-79 year age-group had more hypertension (55.5%) and diabetes (42.3%), while those ≥80 years had higher ischemic heart disease (10.7%) and cancer (6.5%). Morbidity was significantly associated with age, sex, type of family, occupation, and BMI. Conclusions A substantial burden of chronic and age-related conditions was observed among the elderly, with clear socio-demographic variations. Females and the oldest-old were especially vulnerable. Strengthening community-based screening, promoting lifestyle modification, and providing gender- and age-sensitive interventions are essential for improving geriatric health outcomes.
Copyright (c) 2025 Ravinabahen Patel, Kinner Patel https://creativecommons.org/licenses/by-nc-sa/4.0
Comparative Impact of Refractive Correction Modalities on Quality of Life in Myopic Astigmatic Patients: A Prospective Observational Study
Background: Refractive errors, particularly myopic astigmatism, significantly affect visual function and quality of life (QoL). LASIK surgery has become a popular corrective option, offering spectacle independence and rapid visual recovery. However, comparative evidence on patient-reported outcomes between femtosecond laser-assisted and mechanical microkeratome-assisted LASIK remains limited. This study aims to evaluate the impact of LASIK on QoL using the validated Quality-of-Life Impact of Refractive Correction (QIRC) questionnaire and to compare outcomes across surgical techniques and nonsurgical correction methods. Material and methods: This prospective observational study included 150 patients with myopic astigmatism, aged 20–50 years, divided into three groups: femtosecond LASIK (n = 50), microkeratome LASIK (n = 50), and spectacle/contact lens users as controls (n = 50). The QIRC questionnaire was administered preoperatively and at one-month postoperatively for LASIK groups, and once for the control group. QIRC scores were analyzed for total, functional (Q1–Q13), and emotional (Q14–Q20) domains. Statistical comparisons were conducted using paired and independent t-tests, ANOVA, and effect size estimates. A clinically meaningful QoL improvement was defined as a ≥10-point increase in total QIRC score. Results: Both LASIK groups demonstrated statistically and clinically significant improvements in total QIRC scores (femtosecond: +14.20 ± 5.3; microkeratome: +12.37 ± 4.8; p < 0.001). Postoperative scores in LASIK patients were significantly higher than those in the control group (p < 0.001). No statistically significant difference was observed between the two surgical techniques in postoperative QoL (p = 0.7865). Subscale analysis showed significant improvements in both functional and emotional domains, with females reporting greater gains in emotional well-being. No intraoperative or postoperative complications were recorded. Conclusion: LASIK significantly enhances quality of life in patients with myopic astigmatism, with comparable outcomes between femtosecond laser and mechanical microkeratome techniques. The QIRC questionnaire proved effective in quantifying patient-perceived benefits, supporting its use in routine refractive surgery assessment. Integration of PROMs into clinical practice can facilitate more holistic and personalized patient care.
Copyright (c) 2025 Ankit S Varshney, Mahendrasinh D Chauhan https://creativecommons.org/licenses/by-nc-sa/4.0
Role of MRI in Evaluation of Compressive Myelopathy
Background: Compressive myelopathy is a critical condition that can result from various etiologies, including trauma, infection, neoplasms, and degenerative changes. MRI is considered the gold standard for assessing spinal cord compression, owing to its excellent soft tissue contrast and ability to produce multiplanar images. Objective: This study aims to evaluate the role of MRI in diagnosing and characterizing compressive myelopathy, with a focus on differentiating between extradural and intradural lesions. Methods: A cross-sectional study was conducted on 50 patients with suspected compressive myelopathy referred to the Department of Radiodiagnosis, Gauhati Medical College & Hospital, Guwahati, Assam. MRI scans were performed using a 1.5 Tesla Siemens Avanto machine. The lesions were categorized based on location (extradural vs. intradural) and etiology (trauma, infection, neoplasms, etc.). Results: The most common causes of compressive myelopathy was found to be infections (30%) and trauma (40%). Extradural lesions accounted for 84% of cases, while intradural lesions were less common (16%). MRI accurately identified cord compression, vertebral body destruction, and epidural soft tissue components in all cases. Trauma patients showed cord edema/contusion in 100% of cases, while infection cases demonstrated vertebral body destruction and pre/paravertebral collections in all cases. Neoplasms were predominantly intradural, with neurofibromas and meningiomas being the most common. Conclusion: MRI is an indispensable tool for the evaluation of compressive myelopathy, providing detailed information on the location, extent, and nature of spinal cord compression.
Copyright (c) 2025 Ankur Kumar Phukan, Bijit Kumar Duara, Siddhartha Sarma Biswas, Chittaranjan Sarma https://creativecommons.org/licenses/by-nc-sa/4.0
Lymph Node Cytopathology Reporting Based on the 2020 Sydney System Guidelines: Correlation Between Histopathology and Cytology
Introduction: Fine Needle Aspiration Cytology (FNAC) is a useful method for diagnosing lymph node pathology. The updated Sydney System (2020) provides clear guidelines for categorizing and reporting FNAC results, promoting uniformity in terminology and criteria. This standardization is a significant step forward in lymph node pathology diagnosis. FNAC is a straightforward technique for diagnosing and assessing lymphadenopathies, but the presence of numerous conditions and cytomorphological similarities can complicate the diagnosis. This study aims to analyze lymph node cytopathology reports following the 2020 Sydney System guidelines and compare them with histopathological findings. Aim: The study assessed lymph node lesions using the Sydney system over 18 months and calculated the Risk of Malignancy (ROM) for each category by comparing it with histopathology diagnoses in available cases. Materials and Methods: An observational study was conducted from January 2022 to June 2023 at a tertiary care center's Pathology department. The study analyzed 260 lymph node aspirates collected over a one-and-a-half-year period using fine-needle aspiration cytology (FNAC). The aspirates were classified based on the Sydney System into five categories: L1 - non-diagnostic/inadequate, L2 - benign, L3 - atypical cells/atypical lymphoid cells of undetermined significance, L4 - suspicious for malignancy, and L5 - malignant. The accuracy of cytology and ROM was evaluated by comparing them to histopathology, the gold standard diagnosis. Results: Distribution of 260 cytological diagnoses of lymphadenopathy classified in the Sydney system by category were as follows: L1-16 (6.00%); L2-161 (62.00%); L3-06 (2.30%); L4-07 (2.70%); and L5-70 (27.00%) cases. Histopathology was considered the gold standard in 53 cases, revealing malignancy rates (ROM) of 0%, 3%, 66.66%, 100%, and 100% in each category. Cytological diagnosis showed a sensitivity of 95.65%, specificity of 96.29%, Positive Predictive Value (PPV) of 95.65%, Negative Predictive Value (NPV) of 96.29%, and diagnostic accuracy of 96%. Reactive lymphadenitis was the most common benign lesion in 88 (33.85%) cases, while metastatic carcinoma was the most common malignant lesion in 63 (24.30%) cases. Conclusion: The Sydney system for lymph node cytology reporting ensures standardized terminology and reproducibility in reports. It helps guide clinicians on follow-up and ancillary studies in atypical and equivocal cases. In cases classified as non-diagnostic (L1), a repeat procedure or biopsy is recommended to prevent false negative diagnoses.
Copyright (c) 2025 Avani Patel , Keval Patel, Hiralben Rameshchandra Barot, Chandrikaben Chhaganbhai Vaniya https://creativecommons.org/licenses/by-nc-sa/4.0
The Prevalence of Metallo-β-lactamase (MBL) in Gram Negative Bacilli and their Antimicrobial Susceptibility Pattern at Tertiary Care hospital, Vadodara
Background: Antimicrobial resistance is the major threat due to broad spectrum antimicrobials are being used in community practice. The Metallo-β-lactamases (MBLs) in gram negative bacteria have emerged as a major cause of health care associated infections. They hydrolyse all beta-lactam antibiotics including extended spectrum cephalosporins and carbapenems at the same time it is not inhibited by serine beta-lactamase inhibitors like clavulanic acid, sulbactam, and tazobactam and are resistant to many antibiotics. The present study is aimed to determine the prevalence of Metallo-β-lactamase (MBL) in gram negative bacilli and their antimicrobial susceptibility pattern at tertiary care hospital, Vadodara. Material and methods: Total 1350 Clinical specimens were included in the study. The isolates were identified as per standard microbiological procedures od the laboratory such as staining, colony morphology & biochemical reactions. All the isolates were subjected to antibiogram study for the antibiotics plus a phenotypic screening test for MBL was done by disc diffusion test using single Imipenem disc by modified Kirby Bauer disk diffusion method. 117 Imipenem resistant isolates were tested for MBL by Imipenem EDTA combined disc synergy test as a confirmatory test. Results: The prevalence of MBL producing isolates were 6.39%. Maximum number of MBL producers were isolated from the Medicine ward (19, 40.42%) and ICU (11, 23.40%). Maximum number of Specimens containing MBL producers were Pus and Swab (19, 40.42%) followed by Sputum (13, 27.65%). The most common bacterial isolates were Escherichia coli (311) followed by Klebsiella spp. (224) and Pseudomonas aeruginosa (97). The prevalence of MBL production were more common in Pseudomonas spp. (20 out of 97, 20.61%) followed by Acinetobacter spp. (3 out of 19, 15.78%). Polymyxin B and Colistin were the most effective drugs against MBL producers. Conclusion: Prevalence of MBL in our study is 6.39%, which are multidrug resistance though Polymyxin–B and Colistin is still effective treatment option. So there is a need to do surveillance to detect MBL producers, judiciously use Carbapenems along with Antimicrobial Stewardship to prevent their spread.
Copyright (c) 2025 Nisarg Trivedi, Mitesh Kamothi, Bhavesh Gohil, Hitesh Assudani https://creativecommons.org/licenses/by-nc-sa/4.0
Integrating Tradition and Modernity: The Gharana System for Effective Mentorship at GAIMS
This editorial highlights the key features and benefits of the GAIMS Gharana System, an innovative and a unique blend of ancient traditions of knowledge and modern mentoring practices.
Copyright (c) 2025 Ajeet Kumar Khilnani https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiology and Analysis of Mortality in Tertiary Care Hospital in a Metropolitan City, India: A Record Based Study
Background: Mortality statistics are essential for understanding population health, guiding public health efforts, and tracking disease trends. In India, reliable mortality data is often insufficiently documented and analyzed, limiting its utility for identifying leading causes of death. Materials and Methods: A retrospective cross-sectional study was conducted on patient death records from 2018 to 2023 at a tertiary care hospital, excluding incomplete records. Data were analyzed using SPSS version 22.0 and MS-Excel, applying descriptive statistics and Chi-square tests to assess associations at a 5% significance level. Results: From 2018 to 2023, 9,087 deaths were recorded, with a peak in 2020. Non-communicable diseases had the highest mortality share (52.67%–58.75%), followed by communicable diseases (13.05%–21.25%) and postmortem cases (20.49%–26.43%). The mortality trend was significantly linear (p < 0.0001). Most deaths occurred in adults (15–60 years), with no significant gender association. A shift in disease patterns was noted, with communicable diseases peaking in 2020. Conclusion: This study highlights non-communicable diseases as the leading cause of mortality, with a 2020 spike in communicable diseases, seasonal variations, and a predominance of adult deaths, emphasizing the need for ongoing monitoring and targeted interventions.
Copyright (c) 2025 Vrushali Vishal Kulkarni, Amit Yadav https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical and Histopathological Insights Into Soft Tissue Tumors: A Case Series with a Review of the Literature
Soft tissue sarcoma is an uncommon and highly heterogeneous group of malignant tumors. The annual incidence of soft tissue sarcoma is about 50 cases per 1 million people, i.e., 1% of all malignant tumors. The field of soft tissue tumors (STT) is extremely vast; the pattern of tumors is varied, both on benign tumors and on malignant soft tissue tumors. Therefore, it is a very challenging job for a pathologist to give a final diagnosis. Here we have discussed three rare cases of soft tissue tumors.
Copyright (c) 2025 Mangala Nagare, Harsha Dangare, Gauri Metkar, Smita Bhide https://creativecommons.org/licenses/by-nc-sa/4.0