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
Integrating Artificial Intelligence Literacy into the Foundation Course of Competency Based Medical Education: A Proposed Module for Indian Undergraduate Medical Students
The rapid integration of artificial intelligence (AI) into healthcare is transforming clinical practice, medical education, and research. Despite its growing relevance, formal AI literacy remains absent from undergraduate medical curricula in India, creating a gap between technological advancement and medical training. The Competency-Based Medical Education (CBME) curriculum introduced by the National Medical Commission emphasizes digital preparedness and provides an opportunity to address this gap through structured curricular innovation. This editorial proposes the integration of a 20-hour AI literacy module within the MBBS foundation course to equip undergraduate medical students with essential foundational competencies in AI.
Copyright (c) 2026 Ajeet Kumar Khilnani https://creativecommons.org/licenses/by-nc-sa/4.0
Survival Outcomes and Epidemiological Characteristics of Pediatric Leukemia: A Retrospective Cohort Study from a Tertiary Cancer Center in Western India
Background Leukemia represents the most common malignancy among children worldwide and contributes substantially to pediatric cancer mortality, particularly in low- and middle-income countries. Survival outcomes vary widely depending on disease subtype, treatment availability, and healthcare resources. Objectives To evaluate the epidemiological characteristics and survival outcomes of pediatric leukemia patients treated at a tertiary care cancer center in Western India. Materials & Methods A retrospective cohort study was conducted at the Gujarat Cancer and Research Institute (GCRI), Ahmedabad. Pediatric patients aged ≤18 years diagnosed with leukemia in the year 2019 were included and followed up for the period of five years till December 2024. Data were extracted from hospital-based cancer registry records and medical case files. Kaplan–Meier survival analysis was used to estimate overall survival, and regression analysis was performed to identify factors associated with mortality. Results A total of 424 pediatric leukemia patients were included in the study. The cohort comprised 65.6% males and 34.4% females, with a mean age at diagnosis of approximately 8.5 years. Acute lymphoblastic leukemia (ALL) was the most common subtype (77.4%), followed by acute myeloid leukemia (AML) (17%) and chronic myeloid leukemia (CML) (5.7%). The five-year overall survival proportion was 46.2%. Kaplan–Meier analysis demonstrated significant differences in survival according to leukemia subtype (p<0.001). In multivariate analysis, AML was associated with a significantly higher risk of mortality compared with CML (AOR=4.56; 95% CI:1.67-12.46; p=0.003). Conclusion The study demonstrates substantial variation in survival outcomes among pediatric leukemia subtypes, with AML showing significantly poorer prognosis compared with ALL and CML. Strengthening early diagnosis, treatment adherence, and supportive care services in tertiary cancer centers may improve survival outcomes among children with leukemia in India.
Copyright (c) 2026 Helie Raval, Kiruthika Narayanan, Dale Montes, Anand Shah, Chinmay Doctor, Ashishkumar Batham, Mohit Makwana https://creativecommons.org/licenses/by-nc-sa/4.0
Medical textbooks once formed the intellectual backbone of medical education. Today, their place is increasingly challenged by PDFs, online resources, and AI-driven tools. This editorial explores whether the pursuit of digital convenience risks eroding the depth of understanding essential for safe clinical practice.
Amino Acid Dysmetabolism in Type 2 Diabetes Mellitus: Integrated Analysis of Urinary Chromatography and Serum Amino Acid Profiles
Background: Type 2 diabetes mellitus (T2DM) represents a complex metabolic disorder associated with significant disruptions in glucose and amino acid metabolism. Growing evidence indicates that altered plasma amino acid profiles and increased urinary amino acid excretion (aminoacidurias) are defining metabolic features of T2DM, reflecting insulin resistance, enhanced gluconeogenesis, and impaired protein metabolism. Materials and methods: In this case–control study, 115 patients with type 2 diabetes mellitus and 115 age- and sex-matched healthy controls were enrolled. Urinary aminoacidurias were screened using paper chromatography, and serum amino acid profiles were analysed using GC–MS. Differences in amino acid patterns and their correlations with disease severity and metabolic parameters were assessed. Results: The study offers new insights into altered amino acid metabolism in type 2 diabetes and identifies potential biomarkers for diagnosis and disease monitoring. These findings suggest future therapeutic avenues and improve understanding of the metabolic complexity of type 2 diabetes. Conclusion: These findings emphasise the utility of amino acid profiling as a diagnostic and therapeutic approach in type 2 diabetes mellitus management.
Gas chromatography–tandem mass spectrometry
Copyright (c) 2026 Dinesh Kumar Sharma, Sudama Rathore https://creativecommons.org/licenses/by-nc-sa/4.0
Long-Chain Fatty Acid Oxidation Disorder Presenting With Metabolic Acidosis in a Preterm Infant
Long‐chain fatty acid oxidation disorders (LC‐FAODs) are rare autosomal recessive metabolic disorders caused by defects in mitochondrial β‐oxidation. They often present in infancy with hypoketotic hypoglycaemia, cardiomyopathy, hepatic dysfunction or sudden metabolic decompensation. We report a 33.5‐week gestation male neonate with birth weight 1.240 kg, born to non‐consanguineous parents, who presented in the first days of life with persistent metabolic acidosis, hyperkalaemia and hypocalcaemia despite normal blood glucose. Newborn screening by tandem mass spectrometry showed marked elevations of long‐chain acylcarnitines (C14, C14:1, C18) together with hydroxyacylcarnitines (C16‐OH, C18‐OH), a pattern suggestive of very‐long‐chain acyl‐CoA dehydrogenase (VLCAD) or mitochondrial trifunctional protein (TFP) deficiency. Simultaneously, urine organic acid analysis revealed a 55‐fold increase in 4‐hydroxyphenyllactic acid (4‑HPLA) and mild elevation of 4‑hydroxyphenylpyruvic acid (4‑HPPA), raising the possibility of concomitant tyrosinaemia or a mitochondrial disorder. Management with avoidance of fasting, continuous glucose infusion, and medium‐chain triglyceride (MCT) supplementation led to gradual biochemical improvement. This case illustrates the diagnostic complexity of metabolic screening in preterm infants and underscores the importance of integrating clinical context with metabolic data. Early recognition and dietary intervention in LC‐FAOD can significantly improve outcomes.
Long-Chain Fatty Acid Oxidation Disorder
Very-Long-Chain Acyl-CoA Dehydrogenase Deficiency
Copyright (c) 2026 Dharmikkumar S. Patel, Keyur H. Madhu, Deepak R. Thakor, Meet Prajapati https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence of Cyberbullying and Its Association with Internet Addiction and Internet Gaming Disorder Among Medical Students of Western Gujarat; A Cross-Sectional Study
Background: Increasing digital technology use has introduced important behavioural health concerns in student populations, including cyberbullying, internet addiction (IA), and internet gaming disorder (IGD). Objectives: To estimate the prevalence of cyberbullying and examine its associations with IA and IGD among undergraduate medical students in Western Gujarat. Methods: A cross-sectional observational study was conducted over 6 months among 160 MBBS students (≥18 years). Participants completed a socio-demographic proforma, Revised Cyberbullying Inventory (RCBI-R), Young’s Internet Addiction Test–Short Form (YIAT-SF), and Internet Gaming Disorder Scale–Short Form (IGDS9-SF). Data were analysed in jamovi using descriptive statistics and chi-square tests; p<0.05 was considered significant. Results: Participants’ mean age was 19.8 ± 0.9 years; 76 were male and 84 female. Moderate-to-severe IA prevalence was 19.4%, and nearly half had mild IA. Overall, 18.1% reported cyberbullying involvement (11.3% perpetrators; 6.9% victims). IGD prevalence was 7.5%. Cyberbullying involvement increased significantly with greater IA severity (χ²=87.3, df=6, p<0.01). IGD was significantly higher among students involved in cyberbullying than those never exposed (χ²=47.3, df=2, p<0.01). IGD prevalence also rose sharply with increasing IA severity (χ²=96.73, df=3, p<0.01). Conclusions: Cyberbullying, IA, and IGD were prevalent and strongly associated in this medical student cohort, underscoring the need for screening and targeted preventive strategies. Gaming disorder is recognized in ICD-11 as impaired control, prioritization, and continuation despite negative consequences.
Copyright (c) 2026 Jay Daftary, Nileshwari Vala, Yash Hirani https://creativecommons.org/licenses/by-nc-sa/4.0
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
Morbidity Pattern Among Children Aged 3 to 6 Years Residing in an Urban Slum: A Cross-Sectional Study
Background: Children residing in urban slums face a wide range of health problems such as malnutrition, respiratory infections, and gastrointestinal problems. These health problems are driven by factors like poor sanitation, polluted water, limited access to the health care services, lack of proper nutrition and environmental hazards. These issues contribute to poor physical and cognitive development and increased morbidity among the children. The objective of this study was to observe the morbidity and its socio-demographic determinants among slum children. Material and Methods: This cross-sectional study was conducted among children residing in an urban slum in Thane in January 2025 using complete enumeration technique. All the children aged 3 to 6 years residing in a defined urban slum were included in the study. Thorough clinical examination of the subjects was performed through house-to-house survey. Socio-demographic data and clinical examination findings were recorded in the proforma. Data was entered in Microsoft excel and statistically analyzed. Chi-square test was applied. Results: Total 159 children were examined. 51.57% were females and 48.43% were males. 59.12% subjects had morbidity. Respiratory problems were the most frequent (44.03%). Morbidity did not show any statistically significant association with gender, age, religion, or class. It was slightly higher among males (59.74%), and among children aged 3-4 years (61.82%). Also, it was higher among Hindu children (64.29%). Across classes, morbidity was most common in Junior Kindergarten (71.43%), followed by Nursery (52.83%) and Senior Kindergarten (52.00%) (p>0.05). Conclusion: Understanding and addressing children’s health in slum settings should be a priority for the health care services.
Copyright (c) 2026 Namrata Vijay Kulkarni, Ravindra Balaram Gurav, Amit Yadav 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
Prevalence of Hepatitis A Virus in Patients at a Tertiary Care Hospital in Vadodara
Background: The 27 nm, non-enveloped, single-stranded RNA Hepatitis A virus (HAV) belongs to the genus Hepatovirus and family Picornaviridae. The hepatitis A virus, which causes both sporadic and epidemic forms of acute hepatitis, is mostly transmitted through the fecal-oral route, which involves consuming tainted food and beverages. Material and methods: Over a period of 1 year from April 2024 to March 2025, a total of 431 blood samples from clinically suspected Hepatits A patients were received in department of microbiology. Serum was separated and subjected to enzyme immunoassay for detection of HAV IgM Antibody (anti- HAV IgM). Results: During this study period, a total 431 blood samples were processed from suspected Hepatitis A cases out of which 112 (26%) samples were found to be positive for HAV IgM Antibody (anti- HAV IgM). Conclusion: HAV causes AVH most commonly in early childhood and a small number of adolescents and adults. Females are more commonly infected than males. The preventive strategies and control measures of hepatitis A will be determined by future definition of HAV epidemiology in the Central Karnataka region, India.
Copyright (c) 2026 Muthukumaran, Mitesh Kamothi, Ritapa Ghosh 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
Isolated Breast Hydatid Cyst: A Rare Case Report
Echinococcosis, caused by Echinococcus granulosus, is a significant yet uncommon zoonotic disease. Humans become infected by eating food contaminated with dog feces or by coming into close contact with animals; the liver and lungs are usually affected. Nevertheless, breast hydatid cysts are extremely uncommon, making for only 0.27% of all occurrences. This report describes the case of a 37-year-old woman who had been experiencing pain and swelling in her right breast for six months.
Copyright (c) 2026 Rutu B Chapla, Pankti D Panchal, Asha D Halpati, Hardik K Bhavsar 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
Impact of Counselling and Health Education on Treatment Adherence and Outcomes in MDR-TB Patients
Background: Multidrug-resistant tuberculosis (MDR-TB) poses a major public health challenge due to prolonged treatment, high pill burden, adverse drug reactions (ADRs), and poor adherence. Non-adherence is strongly associated with unfavourable outcomes, morbidity, and mortality. Counselling and health education are critical interventions to sustain motivation, improve adherence, and enhance treatment outcomes. This study evaluates the role of counselling in MDR-TB management within the Ahmedabad Municipal Corporation (AMC). Objectives: To assess knowledge and self-care practices related to infection control among MDR-TB patients. To explore patients’ perceptions regarding the role of counselling in treatment adherence. To identify challenges encountered by counsellors in delivering effective counselling. Methodology: A community-based cross-sectional study was conducted from February–October 2021 across five randomly selected TB units under AMC. A total of 115 MDR-TB patients who completed treatment between January–September 2021 were interviewed using a semi-structured proforma. In-depth interviews with five TB counsellors were also conducted. Data were collected through telephonic interviews, home visits, and open-ended discussions. Results: Of 115 patients, most acknowledged counselling as pivotal in adherence and infection control. Knowledge of self-care practices was limited, with males and less-educated patients scoring significantly lower. Counsellors identified stigma, lack of family support, and ADRs as major challenges. Nonetheless, their role was perceived as essential in sustaining adherence and facilitating treatment completion. Conclusion: Counselling and health education substantially influence adherence and outcomes in MDR-TB patients. Strengthening patient-centred counselling strategies is crucial to improve treatment success and reduce MDR-TB burden.
Copyright (c) 2026 Karuna A Vasava , Sonal Shah Parikh, Veneel A. Parikh , Ashadevi H. Sisodiya https://creativecommons.org/licenses/by-nc-sa/4.0
Histopathological Spectrum of Salivary Gland Tumors and Tumor-like Conditions: A Retrospective Study at a Tertiary Care Centre
Background: Salivary gland lesions represent a broad and heterogeneous spectrum of both neoplastic and non-neoplastic pathologies. These conditions frequently exhibit significant overlapping histo-morphological patterns, which present considerable diagnostic challenges for pathologists. Definitive characterization of these lesions relies primarily on comprehensive histopathological examination, judiciously supplemented by immunohistochemistry (IHC) to achieve accurate subtyping and to facilitate precise prognostic stratification. Aims and Objectives: This study was meticulously designed with two primary objectives: first, to systematically delineate the histopathological spectrum of salivary gland tumors and tumor-like conditions that are routinely encountered at a major tertiary care referral center. Second, a crucial aim was to critically evaluate the diagnostic yield of fine-needle aspiration cytology (FNAC) and to assess the role of IHC in establishing definitive and accurate diagnoses for these complex lesions. Materials and Methods: A total of fifty-one salivary gland specimens were meticulously subjected to retrospective review. Comprehensive data retrieved from departmental archives. Final diagnoses were stratified into three distinct categories: benign tumors, malignant tumors, and tumor-like or non-neoplastic conditions. FNAC reports were subsequently compared with the histopathological outcomes to compute key diagnostic performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Results: The study cohort comprised 51 patients, consisting of 29 males and 22 females, which yielded a male-to-female ratio of 1.3:1. The mean age of the cohort was determined to be 43.2. The parotid gland was the most commonly involved anatomical site (80.4%), followed by submandibular gland (11.8%) and minor salivary glands (2%). Benign tumors constituted 45.1% of all cases, while malignant tumors accounted for 19.6%, and tumor-like lesions represented 35.3%. Pleomorphic adenoma (35.3%) emerged as the most frequent benign tumor, with Warthin tumor (7.8%) being the second most common. Mucoepidermoid carcinoma (5.9%) was the most common malignancy. Tumor-like conditions, primarily constituted chronic sialadenitis (17.6%). FNAC demonstrated 86.7% diagnostic accuracy, with 100% specificity but only 33.3% sensitivity for malignancy (n=30). Selective IHC, including markers like DOG-1 and SOX10, provided crucial diagnostic information, and the Ki-67 index ranged from 3-10%. Conclusion: Benign tumors, particularly pleomorphic adenoma, unequivocally predominated within this series, with mucoepidermoid carcinoma identified as the most frequently encountered malignancy. FNAC consistently demonstrated excellent specificity but exhibited notable limitations in sensitivity for malignancy detection. Consequently, the judicious and problem-oriented application of IHC substantially enhanced diagnostic accuracy in cases presenting with morphologically ambiguous lesions, highlighting its indispensable role in definitive diagnosis.
Copyright (c) 2026 S Preetha, R Hemapriya, P Priyadharshini 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
Cribriform Variant of Adenoid Cystic Carcinoma of the Hard Palate: A Case Report
Adenoid cystic carcinoma (ADCC) is an uncommon malignant tumor of the salivary glands, often involving the palate. It is notorious for its indolent yet infiltrative behavior, characterized by perineural invasion and late recurrences. Its presentation may overlap with benign odontogenic lesions, creating diagnostic dilemmas. A 40-year-old male presented with a 6-month history of swelling, pain, and tooth mobility in the left maxillary region, accompanied by occasional bleeding. Computed tomography revealed a multilocular hypodense lesion extending from the left maxilla to the palate with bone destruction. Radiological impression suggested an odontogenic tumor. Histopathological examination of an incisional biopsy confirmed adenoid cystic carcinoma, cribriform type. The patient underwent partial maxillectomy with adjuvant radiotherapy. ADCC in the minor salivary glands can radiographically resemble ameloblastoma or other multilocular lesions, leading to potential misdiagnosis. Histopathology remains the cornerstone for diagnosis, grading, and prognosis determination. Radical surgical excision with tumor-free margins combined with postoperative radiotherapy offers the best control. Long-term surveillance is essential due to its unpredictable late metastasis. Palatal lesions with multilocular radiolucency warrant histopathological confirmation before definitive management. Early detection and multidisciplinary treatment planning are vital for improving survival outcomes.
Copyright (c) 2026 Bhushan M. Warpe, Shweta S. Joshi, Bhumika M. Siddhpara, Prexa M. Dudhagara https://creativecommons.org/licenses/by-nc-sa/4.0
Risk Profiling and Prevalence of Type 2 Diabetes Mellitus in a District-Level Population: A Cross-Sectional Study
Background: India has emerged as the diabetes capital of the world, a trend largely attributed to rapid industrialization and urbanisation, which have contributed to significant lifestyle changes and an epidemiological transition. Objective: To estimate the prevalence of Type 2 Diabetes Mellitus among people of Gandhinagar District. To identify and analyse the sociodemographic and lifestyle-related risk factors associated with Type 2 Diabetes Mellitus in the district population. Material and methods: A cross-sectional analytical study was conducted among 600 participants selected from each of the four talukas of Gandhinagar, ensuring representation of both rural and urban populations through probability-proportional-to-size sampling. Data were collected using a pretested and predesigned proforma. Information on sociodemographic and behavioural factors, family history, and physical measurements was obtained. Random blood sugar (RBS) levels were measured for all participants; individuals with RBS >200 mg/dL underwent HbA1c testing. Data were analyzed using Excel 2019 and SPSS v27. Results: The prevalence of T2DM was 10.66% (64/600), with 37.5% (24/64) being newly diagnosed. Significant associations were observed with increasing age, reduced physical activity, smoking, and obesity (p<0.05). Insignificant associations were found with gender, socioeconomic status, alcohol consumption, family history of diabetes, or frequency of eating meals outside the home. The highest prevalence was noted in the 46–55 years age group. Dehgam taluka exhibited the highest proportion of undiagnosed cases, which may be attributed to its predominantly rural population. Conclusion: High prevalence of modifiable risk factors, targeted primary prevention strategies are essential to curb the rising burden of T2DM in the region.
Copyright (c) 2026 Karankumar A Desai, Jinal Ben Nogas, Pratik Parekh, Ashadevi H Sisodiya https://creativecommons.org/licenses/by-nc-sa/4.0
Bone Microarchitecture Quantification on High-Resolution Peripheral QCT inPre-Menopausal Women
Bone health depends not only on bone mineral density (BMD) but also on microarchitectural integrity, which strongly influences skeletal strength and fracture risk. Conventional dual-energy X-ray absorptiometry (DXA), while widely used, provides only areal BMD and lacks the ability to capture three dimensional microarchitecture. This limitation is particularly important in premenopausal women, where fragility fractures may occur despite normal BMD values. High-resolution peripheral quantitative computed tomography (HR-pQCT) overcomes these shortcomings by enabling in vivo, three-dimensional assessment of trabecular and cortical compartments with high spatial resolution. The technique provides volumetric BMD, detailed microstructural parameters, and finite element analysis (FEA)-based estimates of mechanical competence. This review synthesizes current evidence on the application of HR-pQCT in premenopausal women. Normative data demonstrate generally favourable trabecular and cortical profiles in this group, yet studies reveal that women with idiopathic osteoporosis or fragility fractures exhibit significant cortical thinning, increased porosity, and disrupted trabecular organization despite near-normal BMD. HR-pQCT has also provided insights into skeletal alterations in metabolic disorders, diabetes, amenorrhea, and endocrine diseases, underscoring its role in detecting early microstructural compromise. Moreover, FEA derived from HR-pQCT images offers functional estimates of stiffness and failure load, strengthening its predictive value for fracture risk. Despite its clinical promise, HR-pQCT adoption is limited by cost, availability, and lack of standardized reference ranges for premenopausal women. Nonetheless, ongoing technological advances and longitudinal research are likely to establish HR-pQCT as an essential tool for early detection of skeletal fragility, monitoring treatment response, and guiding preventive strategies in young women.
Copyright (c) 2026 Anshu Kumari, Shivanshu Chauhan , Ashish Kumar Shukla https://creativecommons.org/licenses/by-nc-sa/4.0
A Descriptive Study of Clinical Profile of Fever with Thrombocytopenia at Tertiary Care Centre of Maharashtra
Introduction: Fever is a pervasive and ubiquitous theme in human myth, art and science. Fever is such a common manifestation of illness that it is not surprising to find accurate descriptions of the febrile patients in early-recorded history. A fever rarely comes without other symptoms and sign. It is often accompanied by specific complaints or pattern. Many times, it is associated with low platelet count. The normal platelet count is 150000-450000/ μL. Thrombocytopenia is defined as platelet count less than 150000/ μL. Material and Methods: The present study was prospective observational study conducted on patients, who were admitted at tertiary care hospital in urban setting during Feb 2013 to July 2014. This study conducted at Government medical college and Hospital, Latur. Sample size was 200. Results: The present study, conducted on 200 patients with fever and thrombocytopenia, revealed that the majority of cases occurred in young adults, with 57% belonging to the 15–30 years’ age group and a male predominance (M: F = 2.12:1). Dengue fever (40%) emerged as the leading cause, followed by malaria (33%), while septicemia (8%) was the most common contributor to mortality. Most patients presented with platelet counts less than 50,000/cumm showed bleeding manifestations 34% of cases, predominantly petechiae and purpura (70%). The overall recovery rate was good (96%), with mortality observed in 4% of cases, largely due to septicemia and severe thrombocytopenia (< 20,000/cumm). Conclusion: These findings emphasize that fever with thrombocytopenia is a significant clinical presentation in hospitals, requiring careful evaluation to differentiate between infectious etiologies.
Copyright (c) 2026 Manoj Jagdale, Pralhad Potdar, Darshan Patel, Amitkumar Patil https://creativecommons.org/licenses/by-nc-sa/4.0
The Diagnostic Approach to Headache in Otorhinolaryngology: A Systematic Review
Headache is a broad term that encompasses various types of head and neck pain syndromes. It is a ubiquitous symptom that frequently prompts patient presentation to otorhinolaryngology (ENT) clinics. While most headaches are primary headache disorders, a significant proportion can be secondary to underlying pathologies within the head and neck, falling within the purview of ENT specialists. The challenge lies in differentiating benign primary headaches from potentially serious secondary causes. This systematic review aims to synthesize the current literature on the diagnostic approach to headaches in otorhinolaryngology, focusing on the essential elements of history taking, physical examination, specific ENT-related differential diagnoses, appropriate investigations, and the crucial role of red flag identification.
Copyright (c) 2026 Manish Gupta, Monica Gupta, Akanksha Gupta https://creativecommons.org/licenses/by-nc-sa/4.0
The Great Imitator: A Case Series of Leprosy Mimicking Other Diseases
Leprosy, caused by Mycobacterium leprae, is a formidable spectral disease with heterogeneous clinical manifestations that often overlap with dermatologic, neurologic, and systemic disorders. This case series illustrates leprosy’s capacity to masquerade as systemic lupus erythematosus (SLE), acute inflammatory demyelinating polyradiculoneuropathy (AIDP), and cutaneous lymphoma, emphasizing the challenges in timely diagnosis. Three patients demonstrated characteristic features of these distinct conditions: a young female presenting with malar rash and alopecia mimicking SLE, an elderly male with progressive neuropathy initially linked to AIDP following hepatitis B infection, and a middle-aged female with chronic indurated plaques and constitutional symptoms suggestive of cutaneous lymphoma. Despite initial diagnostic ambiguity guided by clinical and laboratory findings, histopathological evaluation with Fite-Faraco staining confirmed leprosy across all cases, revealing lepromatous to borderline tuberculoid subtypes. These cases reinforce leprosy’s reputation as a “great imitator” and underscore the necessity of including it in differential diagnoses for atypical presentations, even in non endemic regions. Histopathology remains indispensable for definitive diagnosis, particularly when classic signs such as sensory loss are subtle or not clinically apparent, or when nerve thickening is overlooked due to human error—underscoring the importance of sharpening clinical touch and thorough examination. Enhanced clinical suspicion and collaborative multidisciplinary evaluation are crucial to prevent diagnostic delays and mitigate long-term complications in this protean disease.
Copyright (c) 2026 Maitri Patel, Ritu Singh, Roshni Vahora, Ankush Ajbani, Raksha Patel 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
Hyperhomocysteinemia and Ischemic Brain Injury: A Rare Case of Cystic Encephalomalacia in an Adult
Cystic Encephalomalacia refers to the destruction of brain tissue following cerebral infarction and ischemia, infection, head trauma, or other injury. Cystic encephalomalacia (CE) is a most rare disease in adults. Though multiple causative factors come into play, hyperhomocysteinemia is now regarded as a potent aetiology. Here, we describe a 48-year-old male with previous history of cerebrovascular accident (CVA) who was admitted with multiple episodes of seizures. MRI showed chronic infarcts with cystic encephalomalacia changes, and metabolic screening demonstrated elevated levels of homocysteine. This is a case showing the significance of metabolic factors in ischemic cerebral injury and early screening. Differential diagnosis of CE from other changes due to ischemia is of paramount importance to ensure proper treatment and prognosis.
Copyright (c) 2026 Suman G R, Bhargavi K C, Rashi Reddy P, Anjali C Patil, Ajay R https://creativecommons.org/licenses/by-nc-sa/4.0
Modified Tubularized Incised Plate (TIP) Urethroplasty in Distal Penile Hypospadias - A Tertiary Care Experience
Background: After the advent of the Snodgrass tubularized incised plate (TIP) urethroplasty technique for the correction of distal penile hypospadias and urethroplasty complications like urethrocutaneous fistula, meatal stenosis, and glans flap dehiscence in 2% of cases in the year 1994, it became a popular technique among hypospadias surgeons for the correction of distal penile hypospadias irrespective of the intrinsic clinical parameters. The issue of the thin membranous distal urethra, inadequate urethral plate, small conical glans and associated complications following the TIP procedure are well described. Objectives of the study were to find out the surgical procedure undertaken and the outcomes in distal penile hypospadias in our institute. Materials and Methods: This is a retrospective study on distal penile hypospadias operated on in the department of plastic surgery of our institute from April 2017 to March 2022. Results: The present study had a total of 96 boys with distal penile hypospadias; ages ranged from 2 years to 26 years, with a mean age of 5.02 years and a standard deviation of 3.47 years. It was found that 84 (87.5%) of cases of distal penile hypospadias were managed with the modified TIP procedure, and 12 (12.5%) cases were managed with Byars' stage procedures. It was found that 64 (66.7%) of the outcomes were uneventful, and in 32 (33.3%) cases, urethroplasty complications were noted, consisting of preputial flap loss in 3.1%, glans flap dehiscence in 9.4%, meatal stenosis in 9.4%, urethrocutaneous fistula in 8.3% of cases, meatal stenosis with fistula in 1%, and urethral stricture in 1 (2.1%) of cases. Conclusion: Tubularized incised plate urethroplasty, or its modified version of including an extra 3mm to 4mm of penile skin lateral to the urethral plate on either side, is found suitable in the majority (87.5%) of the cases of distal penile hypospadias but not all.
Copyright (c) 2026 Pruthwiraj Singh, Tanmaya Mahapatra, Siva Rama Krishna M, Prem Prakash Mallick https://creativecommons.org/licenses/by-nc-sa/4.0
Platelet Indices as Diagnostic Clues in Dengue Fever - A Comparative Study
Background: Dengue fever (DF), a mosquito-borne illness caused by the dengue virus, poses significant public health challenges, particularly in tropical and subtropical regions. In India, DF is increasingly affecting rural areas, primarily spread by Aedes albopictus and Aedes aegypti mosquitoes. The disease manifests in various forms, including dengue hemorrhagic fever and dengue shock syndrome, often leading to severe health complications. Objective: This study aimed to analyze the hematological profiles, with a focus on Platelet Indices (PIs), in dengue seropositive patients to understand their role in disease progression and management. Materials & Methods: An observational, cross-sectional study was conducted at ACS Medical College and Hospital over one month, involving 100 dengue seropositive patients. Platelet indices, including platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), were obtained through complete blood counts (CBC) on days one and three of admission. Patients were categorized based on platelet count and age for statistical analysis using Chi-Square tests and paired t-test. Results: The study cohort had a mean age of 22.97 years, with a notable predominance of younger individuals. Significant deviations in platelet counts were observed across various antigen categories, with thrombocytopenia being prevalent. The analysis indicated that antibody-dependent enhancement (ADE) and complement system activation by NS1 and heterotypic antibodies contribute to severe dengue manifestations. Statistical tests confirmed the significant impact of antigen types on platelet counts. Conclusion: Platelet indices provide critical insights into the disease progression of dengue fever, serving as valuable predictive tools for diagnosing and determining treatment outcomes. These indices help identify ongoing platelet destruction, guiding the need for platelet transfusions. Future research should focus on validating the predictive power of PIs in larger cohorts and developing models incorporating clinical parameters for improved diagnosis and treatment strategies. Understanding the molecular mechanisms of ADE and complement activation could lead to targeted therapies, enhancing public health strategies for managing dengue outbreaks.
Copyright (c) 2026 Archana Mohanraj, Prakashiny Baburaj, Keerthini Ganesan 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