GSL Medical College & General Hospital

Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Among its subtypes, non-small cell lung carcinoma (NSCLC) accounts for approximately 80% of cases. Accurate staging of NSCLC is crucial for determining the most appropriate therapeutic approach and predicting patient outcomes. While contrast-enhanced computed tomography (CT) is the standard imaging modality for staging, integrated positron emission tomography-computed tomography (PET-CT) has emerged as a valuable tool, offering functional and metabolic insights beyond anatomical imaging. This study aims to compare the staging accuracy of PET Aim: -CT with contrast-enhanced CT thorax in NSCLC patients and evaluate the impact of PET-CT on disease staging and subsequent patient management. A cross-sectional Methods: study was conducted on 87 biopsy-proven NSCLC patients over a two-year period. Each patient underwent both contrast-enhanced CT and PETCT. Staging differences were analyzed, and statistical tests were applied to assess the sensitivity, specicity, and predictive values of each modality. Results: PET-CT led to upstaging in 27.59% of cases and downstaging in 4.60% of cases compared to CT alone. PET-CT demonstrated superior sensitivity and specicity, particularly in detecting satellite nodules, lymph node metastases, and distant metastases. It improved TNM staging accuracy and inuenced management decisions in 32% of cases, with 24% undergoing treatment modications based on PET-CT ndings. Conclusion: PET-CT provides a more comprehensive assessment of NSCLC staging compared to CT, reducing both under- and overestimation of disease extent. Its ability to rene staging and guide management decisions underscores its importance in NSCLC evaluation. Incorporating PETCT into routine staging protocols can enhance treatment planning and improve patient outcomes.

Background: Neurosonography (NSG), also known as transcranial ultrasound (TCU), is an essential bedside imaging tool for evaluating neonatal brain pathology, particularly in preterm infants. Neonatal Brain Hemorrhage (NBH), including Germinal Matrix Hemorrhage (GMH) and Intraventricular Hemorrhage (IVH), is a signicant cause of morbidity and mortality in preterm neonates. Early detection using NSG can aid in timely intervention and improve outcomes. This study aimed to evaluate neonatal brain hemorrhage (NB Aim: H) in preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) using transcranial ultrasound, determine the frequency and grading of NBH, assess associated risk factors, and analyze ultrasound ndings related to other neonatal brain abnormalities. Methods: A hospital-based observational study was conducted over 18 months at the Department of Radio-diagnosis, G.S.L Medical College, India. A total of 110 preterm neonates (gestational age <37 weeks) admitted to the NICU were included. Data on maternal history, perinatal events, neonatal factors, and imaging ndings were collected. Transcranial ultrasound was performed using a PHILIPS Afnity 70G machine with a high-frequency linear probe (7–12 MHz). Statistical analysis was conducted to evaluate the correlation between NBH, gestational age, birth weight, and clinical outcomes. Results Ÿ 62.7% of preterm neonates had abnormal TCU findings, while 25.45% had NBH. Ÿ NBH was more frequent in neonates <28 weeks gestation (47%) compared to 26.9% in 28–32 weeks and 14.6% in 33–36 weeks (p=0.03). Ÿ Low birth weight signicantly correlated with NBH, affecting 55.5% of very low birth weight (VLBW) infants (<1500g). Ÿ The most common ultrasound findings included GMH (23.1%), periventricular flare (18.8%), and IVH (15.94%). Ÿ 83% of NBH cases were detected within 72 hours of life. Ÿ Clinical complications were more frequent in NBH cases, including hypoxic-ischemic encephalopathy (HIE) (25%), post-hemorrhagic hydrocephalus (10.7%), and sepsis (7.14%), though mortality was not significantly impacted. Ÿ Neonates with NBH had signicantly lower APGAR scores at 1 minute (5.21±1.13) and 5 minutes (6.50±1.00) compared to those without NBH. Conclusion: Neurosonography is an effective non-invasive, bedside imaging modality for early detection of neonatal brain hemorrhage (NBH) in preterm infants. It remains the preferred primary imaging tool in NICUs due to its high sensitivity, bedside accessibility, and safety. Gestational age, low birth weight, and APGAR scores were signicant predictors of NBH. Early TCU screening in high-risk neonates can aid in better clinical decision-making and improved neonatal outcomes.

Background: Hilar biliary obstruction is a condition caused by malignant or benign diseases, leading to obstructive jaundice and associated complications. Percutaneous Transhepatic Biliary Drainage (PTBD) is a well-established technique for palliation and biliary decompression in cases where endoscopic approaches are not feasible. This study evaluates the role of PTBD in patien Aim: ts with hilar biliary obstruction, assessing its efcacy in reducing serum bilirubin and liver enzyme levels, alleviating symptoms like nausea and pruritus, and analyzing associated complications. A prospective study was conducted on 34 patients diagnosed with hilar biliary obstru Methods: ction who underwent PTBD between August 2022 and January 2024. Serum bilirubin, Alkaline Phosphatase (ALP), Serum Glutamic Oxaloacetic Transaminase (SGOT), and Serum Glutamic Pyruvic Transaminase (SGPT) levels were measured before and after the procedure. Clinical symptoms and post-procedural complications were also assessed. Among the 34 patients, 71% were male and 29% female, with a mean Results: age of 52.76 ± 8.14 years. The most common cause of obstruction was cholangiocarcinoma (44%), followed by carcinoma gallbladder (23%). PTBD signicantly reduced mean serum bilirubin levels from 11.6 ± 4.3 mg/dL to 3.7 ± 2.9 mg/dL (p<0.0001), ALP levels from 521.0 ± 273.8 mg/dL to 306.8 ± 201.3 mg/dL (p=0.005), SGOT from 109.2 ± 85.1 mg/dL to 50.0 ± 38.5 mg/dL (p=0.004), and SGPT from 77.8 ± 59.8 mg/dL to 34.5 ± 23.4 mg/dL (p=0.0002). Clinical improvement was observed, with nausea decreasing from 71% to 26% and pruritus from 71% to 18% post-procedure. The complication rate was low, with catheter blockage in 6%, sepsis in 3%, and dislodgement in 6% of cases. PTBD is Conclusion: an effective and safe palliative intervention for managing hilar biliary obstruction, signicantly improving biochemical markers and symptom relief. It serves as a viable alternative in patients where endoscopic drainage is not feasible, with a low rate of complications.

Despite advancements in psychiatric treatments, many patients with treatment-resistant disorders are turning to neurosurgical interventions. These include neuromodulation-based surgeries such as deep brain stimulation (DBS) and ablative surgeries such as cingulotomy, offering relief for severe conditions such as post-traumatic stress disorder (PTSD), depression, schizophrenia, obsessive-compulsive disorder (OCD), anxiety, and substance use disorder. While "psychosurgery" has sparked debate due to concerns about patient well-being, recent studies indicate promising symptom improvement rates across various psychiatric conditions while also demonstrating overall safety. Neuromodulation techniques, such as DBS, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT), have evolved in regard to their sensitivity and their ability to target specific brain regions to alleviate psychiatric symptoms. Despite their benefits, these therapies have been shown to elicit side effects such as memory loss and seizures in patients, which has sparked controversy in the use of this technology across clinicians and patients. Ablative therapies, on the other hand, are concerning for being overly invasive in their approach toward psychiatric care. Despite the stigma associated with these neurosurgical interventions for psychiatric care, these procedures often remain a last resort for many patients, highlighting the need for continued research to improve these treatments and expand options for those in need. In this narrative review, we examine the current literature to elicit an understanding of neurosurgical history in regard to psychiatric disorder treatment and its implications for clinical practice.

Objectives The objective of this study was to evaluate the efficacy and adverse effects of non-cultured, nontrypsinized dermabraded epidermal cell graft followed by narrowband ultraviolet B (NB-UVB) therapy for stable vitiligo. Material and Methods A hospital-based and prospective interventional study was carried out on 45 patients (18–65 years) of both genders after approval from the Ethics Committee. The donor site was dermabraded after applying mupirocin ointment, and the material obtained was spread over the dermabraded recipient site. NBUVB phototherapy was initiated 3 weeks after the procedure and given for 3 months. Photographs were taken before the procedure and at the end of 3 rd month of phototherapy and assessed for extent, pattern, and color matching of repigmented area according to physician global assessment (PGA) score and patient satisfaction score (PSS). Dermoscopic improvement was also noted. Results Forty-five patients were enrolled in the study, out of which 43 patients completed the study. According to the intention to treat analysis, results were calculated in all 45 patients. Good to excellent response (50–100% improvement) was seen in 46.7% of patients according to the PGA score and in 57.8% of patients according to PSS. Most patients achieved the same color match with their normal skin at the end of the follow-up (73.3%). The most common repigmentation pattern was diffuse (46.7%), both clinically and dermoscopically. Among the clinical types, vitiligo vulgaris showed the maximum good to excellent repigmentation (61.3% and 77.4% of patients with PGA scores and PSS, respectively). Adverse effects were erythema, infection, and post-inflammatory hyper-pigmentation at the donor and recipient sites, whereas scarring was seen at the recipient site. Conclusion It is a safe, simplified, cost-effective, and less time-consuming technique than earlier techniques and provides good to excellent repigmentation in a considerable proportion of participants.

Background: Esophageal cancer is a major problem in India. The incidence has a geographic variation, being more common in some parts of south India and pockets in the north. The patients usually present in late stages as the symptoms are non-specific, hence patients are treated for other causes over prolonged periods. There has been marked improvement due to the incorporation of a multi-modality approach in the management of these cancers over the last decade. Objective: This study included patients with non-metastatic esophageal cancer who presented to the department of medical oncology between January 2020 and December 2023. The aim was to analyze the clinical and demographic profiles and survival outcomes of patients. Methodology: This is a retrospective study conducted at a tertiary cancer care center in southern India, primarily serving patients from rural areas. Approval from the Institutional Ethics Committee was secured prior to the study (GSLMC/RC:1259A-EC/1259A-05/2024). Case files for all esophageal cancer patients treated at our center between January 2020 and December 2023 were collected from the medical records department and analyzed. We focused on patients diagnosed with non-metastatic esophageal cancer who had received treatment. Results: A total of 47 patients participated in our study, with a mean age of 55 years. The male-to-female ratio was 2:3. Among the participants, 18 (38.3%) were smokers and 12 (25.5%) were alcohol users. The most frequently affected site was the middle thoracic esophagus, with 22 patients (46.8%), followed by the lower third in 15 patients (31.9%), and both the upper one-third and gastroesophageal junction cancers each accounting for five patients (10.6%). Squamous cell carcinoma was the predominant histological type, representing 82% of cases. Stage 2 was the most common stage at presentation, seen in 22 patients (46.8%), followed by stage 3 in 17 patients (36.2%). Twenty patients received neoadjuvant chemoradiotherapy (NACRT), with 13 (65%) receiving a weekly regimen of paclitaxel and carboplatin, while seven (35%) were treated with a CAPEOX (capecitabine and oxaliplatin) regimen alongside radiation (41.4 to 45 Gray). Of these, only eight patients (40%) proceeded to surgery, while 12 patients (60%) did not. Among those who underwent surgery, five patients (62.5%) achieved a pathological complete response. Additionally, 24 patients received definitive CRT, resulting in a complete response in 14 patients (58.3%) and a partial response in 10 patients (41.6%). Three patients defaulted on treatment. The median overall survival for the analyzed group was 10.5 months, with a subset analysis showing that those who had surgery had a survival duration of 12 months, compared to eight months for those who did not undergo surgery. Conclusion: The study concluded that the middle thoracic esophagus is the most prevalent site for esophageal cancer, with squamous cell carcinoma being the predominant histological type. Stage 2 is frequently observed at presentation, followed by stage 3. The standard treatment for locally advanced esophageal malignancies now involves a combined approach with NACRT. Despite advancements in multimodal treatments, the prognosis for esophageal cancer remains poor and requires significant improvement.

Introduction Maternal, placental and foetal factors together or in isolation influence the well-being of the foetus. The two most important causes of intrauterine growth retardation (IUGR) and intrauterine death (IUD) are placental factors and hypoxemia. Material & Methods The present study was a prospective study conducted in the Department of Pathology. Placentas of IUD and IUGR cases were collected and routinely processed. Results There were a total of 52 placentas, 40 from IUD cases and 12 from IUGR cases. Gross infarction was identified in 13.46% cases and microscopic infarction in 23.1% cases which were the most common findings. Conclusion Chorioamnionitis was the most common histological finding in both IUGR and IUD cases. Careful examination of the placenta is necessary in IUD and IUGR cases.

Purpose: Coronavirus disease 2019 (COVID-19) is a viral disease, causing a deadly situation around the world. Significant cases need hospitalization and intensive care. Obese, diabetic, and immunosuppressed people have poor prognosis. Here, we are establishing the link between liver disease and COVID-19. Methods: A thorough investigation was performed across several articles and databases from 2020 to 2022 to assess the impact of COVID-19 on the liver. Results: As of June 2022, we identified 75 articles in electronic databases discussing the hepatic impact of COVID-19. Conclusion: This review delves into the impact of COVID-19 on liver metabolism, specifically how it exacerbates morbidity and mortality in individuals with preexisting chronic liver disease (CLD).

Pemphigus is an autoimmune blistering disorder characterized by the presence of intraepidermal blisters and erosions, primarily affecting the mucosa and/or skin. There are no established Indian guidelines for the management of pemphigus, and Western guidelines cannot be directly applied due to differences in clinicodemographic profiles, comorbidities, and resource limitations. These guidelines aim to provide Indian dermatologists with evidence-based and consensus-driven recommendations for the management of pemphigus vulgaris (PV) and pemphigus foliaceous (PF), taking into account the unique challenges posed by the Indian healthcare setting. The guidelines focus on the comprehensive management of PV and PF, addressing diagnosis, treatment, monitoring, and follow-up. It is intended for dermatologists working in both outpatient and inpatient settings across India. The first draft of the guidelines was prepared by the writing group and then reviewed by 19 national experts in pemphigus management, including inputs from allied specialties. Areas with limited evidence or anticipated variation in recommendations were subjected to rounds of voting, with responses categorized as “strongly agree,” “agree,” “neutral,” “disagree,” or “strongly disagree.” Suggestions were incorporated, and statements were revised until a mean agreement score of 4 or higher was reached across 16 key areas after four voting rounds. These guidelines offer a structured approach to managing pemphigus in India, addressing the need for region-specific recommendations that account for unique challenges such as resource constraints and specific comorbidities in Indian patients. They serve as a valuable resource for dermatologists treating pemphigus in a range of clinical settings.

This narrative review aims to systematically explore and synthesize the current literature on the efficacy and safety of ketamine nebulization and magnesium sulfate as therapeutic interventions in the management of status asthmaticus. The review evaluates clinical outcomes, administration protocols, and potential adverse effects associated with these treatments. Ketamine has proven effective in managing asthma due to its bronchodilator properties, primarily by stimulating nitric oxide and catecholamine release. Magnesium sulfate has shown benefits by interfering with calcium influx, which alleviates bronchospasm and enhances bronchodilation. Both treatments have been associated with improvements in FEV1 and peak expiratory flow rates, which improve blood oxygenation and reduce bronchospasm. Despite the promising results, more research is needed to determine the optimal dosages and administration routes for these interventions. Furthermore, current studies often do not use these treatments as first-line options, which may introduce confounding variables. Future research should focus on establishing clear protocols for the use of ketamine and magnesium sulfate in refractory acute-severe asthma and status asthmaticus. This review highlights the potential for these treatments to improve clinical outcomes when standard corticosteroid therapies are insufficient, suggesting that with appropriate dosing and consideration, they could be valuable additions to the management strategies for severe asthma exacerbations.

Background Chronic spontaneous urticaria (CSU) appears to share some pathomechanisms with metabolic syndrome (MS), such as proinflammatory state, increased oxidative stress, changes in adipokine profile, and coagulation system activation. Aim and Objectives To evaluate clinical and laboratory parameters of MS in CSU patients and to assess relationship of MS with duration and severity of CSU, Ig-E, thyroid-stimulating hormone (TSH), C-reactive protein (CRP), and autologous serum skin test (ASST). Materials and Methods A hospital-based cross-sectional study was conducted on 131 CSU cases and 131 controls who were age- and sex-matched. Duration of the CSU and urticaria activity score (UAS) were noted. Waist circumference (WC), blood pressure, fasting blood sugar, high-density lipoprotein (HDL), triglycerides (TG), CRP, TSH, IgE, and ASST were noted. MS was considered according to Harmonization Asian criteria. Results The percentage of patients with elevated clinical and laboratory parameters of MS was higher in cases compared to controls, in which WC, HDL, and TG were significantly elevated. MS was positive in 25.19% and 14.50% of cases and controls, respectively ( P = 0.044). Cases with MS had a significant higher mean duration (16.60 months) than those without MS (8.81 months) ( P = 0.004). MS was positive in 15.2%, 32.3%, and 36.4% of mild, moderate, and severe UAS patients, respectively ( P = 0.095). Patients with increased TSH and CRP had a significantly higher percentage of MS (68.4% and 40.7%, respectively) than with normal TSH and CRP (15% and 19.4%, respectively) ( P < 0.05), while it was not significant with respect to IgE and ASST. Limitations Small sample size and it was a hospital-based study, therefore, all controls were from the patients attending our outpatient department only and could not be compared with the general population. Conclusion MS is not uncommon in CSU patients. The duration of CSU, CRP levels, and TSH levels have a significant positive correlation with MS. Screening, along with regular surveillance of CSU patients, aids in the early detection of MS and minimizes the risk of cardiovascular disease.

Background Active learning strategies (ALSs) in medical education are valued for their effectiveness but face adoption challenges among educators, underscoring the need for a deeper understanding of their implementation and impact. Aim The aim of the study was to investigate the perceptions of medical educators regarding the effectiveness and challenges of ALS through mentor–learner (ML) web-based discussions. Settings and Design The retrospective cross-sectional study analyzed data from 32 medical educators enrolled in the Foundation for Advancement of International Medical Education Research course at Christian Medical College, Ludhiana. It utilized a mixed-method approach, gathering both quantitative and qualitative data through ML web discussions. Materials and Methods The study used a “dual-method” approach, combining traditional online discussions with a “role-reversal” method on an ML web platform, promoting experiential learning. Participant responses on ALS implementation tasks were collected and analyzed within these discussions. Results Participants shared various ALS for collaborative learning (20), classroom engagement (26), assessing prior knowledge (12), and note-taking during lectures (10). Further, among the 11 ALS examined, the ease of implementation varied significantly among participants ( P < 0.0001). Challenges in ALS implementation included inadequate faculty training (91%), motivation (84%), resource constraints (81%), student (75%), and administrative resistance (69%). Four themes emerged as recommendations for effective ALS implementation: empowering educators, engaging students, streamlining support systems, and monitoring impact. Conclusion The study highlights a mixed perspective of medical educators on ALS. Although ALS was perceived as effective in fostering critical thinking and developing collaborative learning among students, various challenges, such as a lack of skilled faculty and resources, necessitated robust faculty development initiatives.

Scrub typhus is still an underdiagnosed disease despite an increase in incidence as the clinical presentation is often different, leading to a low index of suspicion among doctors. Scrub typhus, an acute febrile disease, is a cause of prolonged fever and pyrexia of unknown origin. It can have varied clinical presentations ranging from mild asymptomatic disease to fatal multi-organ dysfunction. Splenomegaly in scrub typhus has been rarely reported. We report a 30-year-old man presenting with fever, hepatomegaly, massive splenomegaly, lymphadenopathy and lobar pneumonia. Tests for malarial parasite and enteric fever were negative. Bone marrow aspiration showed normal haematopoiesis. IgM scrub was positive. Upon serological confirmation, doxycycline therapy was started followed by a rapid and complete resolution of pneumonia (both clinically and radiologically), splenomegaly and lymphadenopathy. This highlights the importance of recognizing rare clinical manifestations of this common tropical disease. An early diagnosis is required as a delay may lead to complications and a poor outcome.

Introduction: Head and neck cancers are the fth most common globally and second most prevalent in India, with 77,000 annual cases. Radiotherapy, often combined with chemotherapy, is a standard treatment but frequently results in radiation-induced hypothyroidism (RIHT), with incidence rates ranging from 4% to 79%. RIHTsignicantly impacts quality of life, yet thyroid function testing is rarely routine. Hypothyroidism, a common late effect, is irreversible and requires lifelong hormone replacement. Preventive strategies are crucial to minimize this complication in patients undergoing radical radiotherapy with concurrent chemotherapy for head and neck squamous cell carcinoma. Aim & Objectives: This study examines the incidence of radiation-induced hypothyroidism in patients with HNSCC receiving chemoradiation and explores preventive strategies to reduce its occurrence and associated morbidity. Materials and Methods: This prospective study, conducted at GSLMedical College from October 2019 to April 2021, involved patients with head and neck squamous cell carcinoma receiving radical radiotherapy. Eligible patients underwent thyroid function tests before, after treatment, and six months post-radiotherapy. Dose-volume metrics were analyzed, and statistical assessments were performed using SPSS 22.0 and R version 3.2.2. Signicance was set at p < 0.05. The study aimed to evaluate the incidence of radiation-induced hypothyroidism and explore preventive strategies. Results: In our study, 17 out of 31 patients (54.8%) developed radiationinduced hypothyroidism (RIHT) at 6 months post-radiotherapy, with 13 (41.9%) showing clinical hypothyroidism (mean TSH 7.77 ± 2.93, p < 0.001). T4 and T3 levels showed no signicant difference between hypothyroid and euthyroid patients. Cold intolerance occurred in 12.9%, weight gain in 16.1%, dry skin in 29%, and constipation in 35.5% of patients. The mean thyroid dose was similar between hypothyroid (6570.29±587) and euthyroid groups (6541.35±601.13), with no statistically signicant difference. Long-term follow-up is crucial, as RIHT incidence increases over time. Conclusion: Radiation-induced hypothyroidism (RIHT) is a common complication of head and neck radiotherapy, with our study reporting a 54.8% incidence at 6 months. While no clear dose-response relationship was identied, smaller thyroid volumes increased the risk of hypothyroidism. Early detection and long-term follow-up are essential to prevent progression from subclinical to clinical hypothyroidism. Further research is needed to improve predictive models and minimize thyroid exposure during treatment.

Introduction According to Globocan 2022, breast cancer ranks number one among the cancers worldwide. South Asian women have a higher incidence compared to Westerners. Estrogen receptor (ER) and progesterone receptor (PR) positive tumors, termed hormonal receptor-positive tumors, account for most breast cancer presentations. In India, advanced-stage presentations are more common. In metastatic hormone receptor-positive breast cancer, hormonal therapy combined with cyclin-dependent kinase (CDK) 4/6 inhibitors is the standard treatment. Aim This study aimed to analyze the experience with generic palbociclib provided under the Government Health Scheme for metastatic hormone receptor-positive breast cancer at our institution. Methods This retrospective study was conducted on breast cancer patients admitted to a tertiary care center in South India. The data of ER and PR receptor-positive metastatic breast cancer patients who received palbociclib were identified and reviewed using medical records from 2023 to 2024. Results A total of 238 patients were analyzed, of which 41 received palbociclib for hormone receptor-positive metastatic breast cancer. The median age was 49 (33-75), with 53.5% (22) of women above 50. Denovo stage IV presentation was observed in 21 patients (51.2%), while progression to stage IV disease was noted in 11 patients (26.8%), and stages II and III were noted in nine patients (22%). Invasive ductal carcinoma was the most common histology. All patients were ER-positive, and 38 (92.7%) were PR-positive. About 17 patients (41.5%) had visceral metastasis, and 12 (29.3%) had bone-only metastasis. Local recurrence was seen in six patients (14.6%), and bone with visceral metastasis was seen in another six patients (14.6%). Progression within one year of hormonal therapy initiation was observed in 50% (10) of patients. Among 21 patients with upfront metastasis, nine were treated with prior chemotherapy. All patients were given 125 mg of oral palbociclib. Fatigue was the most common side effect in 34.1% (14), followed by myalgia in 21.9% (9), low hemoglobin levels of less than 8 g/dl in 14.6% (6), and nausea and vomiting in only 9.8% (4) of patients. Conclusion Hormone therapy combined with CDK4/6 inhibitors is the backbone of treatment for metastatic hormone-positive breast cancer. However, in developing countries like India, where most patients come from rural areas, using innovator palbociclib may not be feasible for many. With the availability of generic palbociclib under the Government Health Scheme, patients of metastatic hormone receptor-positive breast cancer will receive the protocol-based treatment.

Background and Objective Osteoarthritis is a degenerative joint disease that leads to biomechanical and morphological alterations in the joint. There are various physiotherapeutic interventions available for treating osteoarthritis but there is lack of literature regarding comparison of effectiveness of Forward walking and Retro walking in subjects with Osteoarthritis of knee, hence the need of the study arises. The purpose of this study was to determine the effectiveness between the Forward Walking and Retro-Walking in improving Strength and Function in subjects with Osteoarthritis of Knee. Methods Prospective Cohort study design. 150 subjects who were clinically diagnosed of Osteoarthritis of Knee were assessed and only 66 were recruited who are willing to be in the study and they were randomly allocated into two Groups. In Group I (n = 33) subjects were treated with Conventional Physiotherapy and Forward Walking for 8 weeks, whereas in Group II (n = 33) subjects were treated with Conventional Physiotherapy and Retro Walking for 8 weeks. The outcome of this intervention Function (KOOS) and lower limb strength (knee flexion and extension). Results Statistical analysis of this study data revealed that in between-group comparison showed there is a STATISTICAL significant difference in KOOS and knee flexors and extensors strength. Conclusion This study concluded that Retro Walking is a suitable adjunct to Conventional Physiotherapy in Subject with knee osteoarthritis.

Objectives To study the efficacy and safety of microneedling radiofrequency (MNRF) in the treatment of acne scars. Material and Methods This is a hospital-based and prospective interventional study. A total of 44 patients (18– 55 years old), skin types III-V, with acne scars, were enrolled. Four sessions of MNRF (Lumenis legend PRO Machine, with non-insulated needle tips GEN6, GEN6L; Israel) were done with an interval of 3 weeks between each session and followed up 1 month after the last session. The outcome was assessed by Goodman and Baron’s qualitative and quantitative acne scar grading, physician global assessment (PGA), and patient satisfaction score (PSS). Results Out of 44 patients, four patients could not complete the study. Goodman and Baron’s qualitative assessment showed patients with Grades 2, 3, and 4 were 6 (15%), 17 (42.5%), and 17 (42.5%), respectively. At the end of follow-up, patients with Grades 1, 2, 4, and 4 acne scars were 5 (12.5%), 24 (60%), 10 (25%), and 1 (2.5%), respectively, which were statistically significant ( P < 0.05). Seven patients showed no improvement. Goodman and Baron’s quantitative assessment showed an initial mean of 12.65 and an after-follow-up mean of 8.3, which was statistically significant (P < 0.05). PGA and PSS scores showed excellent to good responses of 70% and 82.5%, respectively. Adverse effects such as post-treatment erythema were seen in all patients, and edema was observed in 12 patients. Post-inflammatory hyperpigmentation was noted in two patients. Conclusion MNRF was found to be effective with a better safety profile for acne scars.

Breast cancer remains a leading cause of morbidity and mortality among women worldwide. Early detection and precise diagnosis are critical for effective treatment and improved patient outcomes. This review explores the evolving role of radiology in the diagnosis and treatment of breast cancer, highlighting advancements in imaging technologies and the integration of artificial intelligence (AI). Traditional imaging modalities such as mammography, ultrasound, and magnetic resonance imaging have been the cornerstone of breast cancer diagnostics, with each modality offering unique advantages. The advent of radiomics, which involves extracting quantitative data from medical images, has further augmented the diagnostic capabilities of these modalities. AI, particularly deep learning algorithms, has shown potential in improving diagnostic accuracy and reducing observer variability across imaging modalities. AI-driven tools are increasingly being integrated into clinical workflows to assist in image interpretation, lesion classification, and treatment planning. Additionally, radiology plays a crucial role in guiding treatment decisions, particularly in the context of image-guided radiotherapy and monitoring response to neoadjuvant chemotherapy. The review also discusses the emerging field of theranostics, where diagnostic imaging is combined with therapeutic interventions to provide personalized cancer care. Despite these advancements, challenges such as the need for large annotated datasets and the integration of AI into clinical practice remain. The review concludes that while the role of radiology in breast cancer management is rapidly evolving, further research is required to fully realize the potential of these technologies in improving patient outcomes.

Three-dimensional (3D) printing technology has revolutionized surgical practices, offering precise solutions for planning, education, and patient care. Surgeons now wield tangible, patient-specific 3D models derived from imaging data, allowing for meticulous presurgical planning. These models enhance surgical precision, reduce operative times, and minimize complications, ultimately improving patient outcomes. The technology also serves as a powerful educational tool, providing hands-on learning experiences for medical professionals and clearer communication with patients and their families. Despite its advantages, challenges such as model accuracy and material selection exist. Ongoing advancements, including bioactive materials and artificial intelligence integration, promise to further enhance 3D printing’s impact. The future of 3D printing in surgery holds potential for regenerative medicine, increased global accessibility, and collaboration through telemedicine. Interdisciplinary collaboration between medical and engineering fields is crucial for responsible and innovative use of this technology.