Ashwini Hospital

BACKGROUNDDengue fever remains a major cause of acute febrile illness in India, particularly in rural areas where diagnostic facilities are limited. Early detection using point-of-care tests helps guide timely management and reduce unnecessary antibiotic use.AIMTo determine the seroprevalence and clinical profile of dengue infection among acute febrile patients attending a rural tertiary care hospital in Maharashtra.METHODSA prospective cross-sectional study was conducted at Ashwini Rural Medical College Hospital and Research Centre, Solapur from May to October 2025. A total of 320 consecutive patients presenting with acute fever of ≤ 7 days duration prior to hospital presentation were enrolled. Patients of all age groups were included. Serum samples were tested for dengue NS1 antigen and anti-dengue IgM and IgG antibodies using a commercial rapid test (Manufacturer: Meril diagnostics; Meriscreen dengue NS1 antigen and IgM + IgG antibodies). A 10% subset (n = 32) was tested by enzyme-linked immunosorbent assay (ELISA) for quality assurance. Patients were classified as recent dengue (NS1+ and/or IgM+), probable secondary infection (IgM+ IgG+), past exposure (IgG+ IgM-), or negative (NS1- IgM-). Clinical data and outcomes were recorded. Statistical analysis included χ2, Mann-Whitney U, and logistic regression (α = 0.05), adjusting for age, sex, platelet count, total leukocyte count, and presence of rash.RESULTSOverall, 28% (90/320) had evidence of recent dengue, while 35% (112/320) showed IgG positivity, and 10% (32/320) had probable secondary infection. Median platelet count was significantly lower in the recent dengue group [78000/mm³; interquartile range (IQR): 55000-110000] compared with non-dengue patients (210000/mm³; IQR: 160000-240000; P < 0.001). The most common symptoms were headache (68%), myalgia (61%), and retro-orbital pain (44%). Antibiotic use prior to testing was 60%; among those diagnosed with dengue, a relative 25% reduction in antibiotic prescriptions was observed following laboratory confirmation. Quality assurance analysis showed rapid test sensitivity of 92%, specificity of 95%, and Cohen’s kappa of 0.85 vs ELISA. Logistic regression identified thrombocytopenia (< 100000/mm³) [adjust odds ratio (aOR) 5.2; 95%CI: 2.4-10.9] and rash (aOR 3.6; 95%CI: 1.8-7.0) as independent predictors of dengue positivity.CONCLUSIONA substantial proportion of acute febrile cases in this rural setting were due to dengue, highlighting the utility of NS1/IgM rapid tests for early diagnosis where molecular facilities are unavailable. Integrating rapid dengue testing into routine fever evaluation can improve case detection and rationalize antibiotic use.

Objective:Our primary objective is to determine the prevalence of various psychiatric comorbidities in patients with epilepsy (PWE) and to assess sleep quality in PWE.Methods:Present study was a hospital based cross sectional study conducted over 2 months (January and February of 2022) that included 242 tribal patients from outdoor patient department in Mayurbhanj district of Odisha. Consecutive sampling was conducted. The patients fulfilling the inclusion and exclusion criteria were first assessed using a semi structured proforma for the socio-demographic data. The International Classification of Epilepsies (ILAE-1981) was used to classify seizure types. We used the Mini International Neuropsychiatric Interview (MINI 7.0.2) to assess psychiatric co-morbidity in all subjects. Hamilton anxiety scale (HAM-A), Hamilton rating scale for depression (HAM-D), brief psychiatric rating scale (BRPS), and young mania rating scale (YMRS) was applied accordingly depending on the psychiatric symptoms. Pittsburg sleep quality inventory (PSQI) was used to measure the sleep quality. Adherence in this study was determined by using a simple yes/no question that if the patient was taking the prescribed medications in the recommended dose, frequency and duration as prescribed by the mental health professional. Non-adherence refers to not taking the prescribed anti-epileptic drug and/or psychotropics if any as per recommended dose and duration as prescribed by the health care provider.Results:The prevalence of major depressive disorder, generalized anxiety disorder, psychotic disorder, and panic disorder was 18.2%, 16.1%, 15.7%, 1.2%, respectively. Hypomania and mania constituted 0.8% and 1.7% of the sample respectively. Suicidality with no other psychiatric illness was seen 2.1% of the population. PSQI scores among PWE had positive correlation with age (r = 0.171, P = 0.008), BPRS scores (r = 0.177, P = 0.006), HAM-D scores (r = 0.436, P = 0.000), and HAM-A scores (r = 0.228, P = 0.000), while negative correlation with duration since last seizure (r = −0.142, P = 0.027). Median age (P = 0.028), median duration of illness (0.009), HAM-D (P = 0.034), and PSQI scores (P = 0.004) were higher among non-adherent PWE. Duration since last seizure had higher median value among adherent PWE (P = 0.000). There is significant association of compliance with side effects (P = 0.020) and number of seizures per year (P = 0.016).Conclusion:Depressive and anxiety disorders are more common psychiatric co-morbidities tribal PWE. When compared to unselected epilepsy patients, tribal PWE had higher prevalence of psychotic spectrum disorders, while lower prevalence of manic and hypomanic disorders. Sleep disturbance is an important indicator for poor maintenance of epilepsy. Non-adherence is associated with poor control of seizure and longer duration of illness. Tribal PWE with depression and poor sleep also have poor adherence. Improving adherence and sleep quality may improve the seizure control. Also, treatment of psychiatric co-morbidities may help in better seizure control. Non association of adherence and unemployment suggests that finance was not a barrier for adherence to treatment in tribal population of Mayurbhanj as most of the PWE were being treated under district mental health program (DMHP).

Introduction: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide and dyslipidemia is the major risk factor for CVD. Aim: The aim of the study was to assess the real-world treatment patterns associated with the use of rosuvastatin + ezetimibe combination therapy for lipid management. Methods: This retrospective multicentric, noncomparative, nonrandomized, observational real-world study was conducted at multiple healthcare centers in India. Patients aged ≥18 years (either sex), with uncontrolled dyslipidemia, familial hypercholesteremia, and mixed dyslipidemias, with persistently elevated levels of low-density lipoprotein cholesterol (LDL-C) despite receiving statin therapy were included. Fasting blood LDL-C was monitored in high, very high, and extreme-risk patients. Results: A total of 1465 patients were enrolled with a mean age of 60.87 years and men predominance (67.49%). Median (range) duration of hypercholesteremia of patients was 4.00 (0.40–19.50) years. The majority of patients were on moderate-intensity statin therapy (54.68%), followed by high-intensity statin (27.37%) and low-intensity statin (17.95%). The majority of patients taking moderate-intensity statins (47.38%) had LDL-C levels between 151 and 200 mg/dL, compared to those taking low (36.50%). Combination rosuvastatin + ezetimibe therapy showed a significant reduction in mean LDL-C levels of patients using low, moderate, and high-intensity statins with a mean difference of 100.63 mg/dL, 94.24 mg/dL, and 92.00 mg/dL ( P &lt; 0.001 each) as well as a significant reduction in LDL-C levels, total cholesterol levels, and triglycerides levels ( P &lt; 0.001 each). Conclusion: Rosuvastatin and ezetimibe therapy was an effective and well-tolerated lipid-lowering agent, offering higher efficacy, especially in the reduction of LDL-C levels.

Avian influenza viruses (AIVs) represent an ongoing threat to global health due to their capacity for genetic evolution, zoonotic transmission, and pandemic emergence. This review highlights recent progress in understanding the molecular mechanisms underlying AIV infection, including viral immune evasion strategies and host-virus interactions. It discusses recent outbreaks involving reassortant strains such as H5N1 and H9N2, and examines their public health consequences. Advancements in antiviral therapy, including resistance patterns, and the development of next-generation vaccines such as messenger RNA and universal influenza vaccines are reviewed. The integration of genomic surveillance, artificial intelligence-driven prediction, and One Health approaches is emphasized as essential for pandemic preparedness. This comprehensive overview aims to provide researchers and policymakers with actionable insights for controlling the evolving threat of avian influenza.

The gut microbiome plays a crucial role in regulating immune responses, influencing susceptibility to viral infections, shaping disease progression, and its outcomes. Emerging research highlights the intricate relationship between gut microbial communities and viral pathogenesis, demonstrating that dysbiosis can compromise antiviral defenses while a balanced microbiome enhances immune resilience. This review explores key microbial mechanisms, including microbiome-mediated immune modulation, interactions with viral replication, and the impact of microbiome on systemic inflammation, highlighting how dietary interventions, such as probiotics, prebiotics, and bioactive compounds, offer potential strategies to modulate gut microbiota and mitigate viral infections. Special emphasis is placed on viruses affecting the gastrointestinal and respiratory systems, including severe acute respiratory syndrome coronavirus 2, norovirus, and influenza. Furthermore, we explore how nutrition-driven microbiome interventions may serve as adjunct therapeutic strategies, improving vaccine efficacy and post-viral recovery. Understanding the role of gut microbiome in viral infections can pave the way for microbiome-driven strategies to combat viral diseases and improve overall health outcomes.

Objective: To conduct an intercenter outcome assessment of maxillomandibular relationships for patients with repaired complete unilateral cleft lip and palate between the ages of 8 and 14 using the GOSLON Yardstick index. Design: Retrospective cohort study. Setting: Ten Comprehensive Cleft Care Centers across India. Subjects: A total of 397 subjects with repaired unilateral cleft lip and palate. Methods: Using GOSLON Yardstick, 397 study models of patients with complete unilateral cleft lip and palate were assessed. The intra-rater and inter-rater reliabilities were assessed using weighted kappa statistics. One-way analysis of variance test was performed to determine if there were any statistically significant differences in GOSLON ratings among the centers. Significance levels were set at P < .05. Results: The inter-rater and intra-rater reliability values of GOSLON ratings were 0.882 and 0.836. The GOSLON ratings across ten different centers range from 3.1 to 3.9. The center with the best score, that is, Center G, with 37.5% of its patients with a GOSLON 4 and 5 combined, whereas Center A with the worst score, that is, 57.5% of its patients with a GOSLON 5. Conclusions: The outcomes vary from fair to poor GOSLON scores among Indiacran centers. Continued efforts to share best practices and improve standardization across centers may enhance the quality of care and decrease the burden of care for patients with cleft lip and palate and their parents.

Breastfeeding is a critical component of infant health and development, providing essential nutrients, antibodies, and immune factors. Despite the recognized benefits, rates of early breastfeeding initiation and exclusive breastfeeding remain suboptimal in India. This systematic review aims to investigate the factors influencing timely initiation of breastfeeding and delayed exclusive breastfeeding in India. A comprehensive literature search was conducted, and studies meeting the inclusion criteria were analyzed. The review identified several key factors influencing breastfeeding practices, including maternal factors (age, education, parity, socioeconomic status), infant factors (birth weight, gestational age, health status), socio-cultural factors (cultural beliefs, traditions, family support), and healthcare system factors (access to skilled birth attendants, antenatal care, postnatal support). Enabling factors for timely breastfeeding initiation included high maternal education, urban residence, delivery in a healthcare facility, and receiving breastfeeding counseling. Impediments included low maternal education, rural residence, home births, lack of antenatal care, and delayed recognition of colostrum importance. Factors influencing exclusive breastfeeding included maternal education, attitudes, confidence in milk production, infant latching and suckling skills, and socio-cultural beliefs. The review highlights the need for a multi-pronged approach to address these factors, including enhancing maternal education, promoting positive attitudes, providing skilled support, addressing socio-cultural beliefs, strengthening healthcare systems, and evaluating interventions such as midwife-led care units. Future research should focus on implementing and evaluating interventions to promote and support exclusive breastfeeding, particularly among working mothers and marginalized communities.

Oral and intravenous iron therapy for the treatment of iron deficiency anemia during antenatal and postnatal period: An expert consensus - IJOGR- Print ISSN No: - 2394-2746 Online ISSN No:- 2394-2754 Article DOI No:- 10.18231/j.ijogr.2025.051, Indian Journal of Obstetrics and Gynecology Research-Indian J Obstet Gynecol

National best practice guidelines for early childhood intervention (ECI) were first published in Australia in 2016, but research into the implementation of these guidelines has been limited. The purpose of this study was to determine the extent to which the role descriptions of ECI positions advertised by Australian employers aligned with the best practice guidelines. Through secondary analysis of 246 online job advertisements for ECI positions, collected over a 5-month period, we examined role descriptions to identify those including descriptions of key best practices. We also examined the extent to which the skills, knowledge, and experience advertised as essential aligned with best practice role descriptions, and what qualifications were required for best practice roles. Over 97% of the advertised roles included components of one or more of the Australian key best practices, but practices related to family and inclusion were included in less than half of these. Few employers advertising best practice-aligned roles required successful candidates to have knowledge, skills, or experience in the corresponding area. Implications of these findings for both research and practice are presented.