Government Medical College, Amritsar

Abstract: Microbial resistance or antimicrobial resistance (AMR) emerged as one of the greatest global health issues of the 21st century, originating from excessive use of antimicrobials. Tackling AMR requires careful and sustainable use of antimicrobials to effectively deal with the health issues it creates. Primary strategies to tackle AMR target precise diagnostics and rational prescribing practices using advanced infection treatment protocols, such as antimicrobial stewardship (AMS). At the same time, technologically advanced diagnostic procedures and biomarker development enable accurate pathogen detection, allowing for more target-oriented outcomes. Alternatively, probiotics, phage therapy, and antimicrobial peptides work as the greatest supporting pillars in the fight against AMR. Vaccination represents a promising advancement in public health, serving as a preventive approach that significantly lowers the need for antibiotics in both human and veterinary practice. From a regulatory perspective, controlling the misuse of antimicrobials is a critical step in safeguarding community health. This includes the complete restriction of over-the-counter antibiotic sales and the prohibition of non-therapeutic antibiotic use across all sectors of society. In addition, environmental strategies, such as reducing antibiotic pollution and improving wastewater treatment, further support sustainable AMR management. Public awareness campaigns and professional training initiatives highlight the importance of responsible antibiotic use; ultimately, the management of AMR requires multifaceted approaches, combining scientific innovation, policy enhancement, and global collaboration. Integrating AMR strategies into the United Nations Sustainable Development Goals (SDGs) can further enhance global efforts towards a healthier and more sustainable future.

Background: Burnout is a significant psychological concern among postgraduate medical residents owing to high workload demands, long working hours, and emotional strain associated with clinical responsibilities. Persistent burnout may negatively affect residents’ well-being and their professional performance. Objective: This study aimed to examine the level of burnout among postgraduate medical residents and explore differences based on selected demographic characteristics. Method: A quantitative cross-sectional design was employed involving postgraduate medical residents from a teaching hospital. Data were collected using the Maslach Burnout Inventory–Human Services Survey (MBI- HSS). Statistical analysis was conducted using descriptive statistics and independent samples t-tests to examine the differences in burnout dimensions across groups. Results: The findings indicated that residents experienced moderate to high burnout levels, particularly in emotional exhaustion and depersonalization. Significant differences were observed across the selected demographic variables. Conclusion: Burnout remains a prevalent issue among postgraduate medical residents, highlighting the need for institutional and psychological interventions to promote mental well-being and sustainable professional functioning of residents. Abstrak Latar Belakang: Burnout merupakan permasalahan psikologis yang signifikan pada residen kedokteran pascasarjana akibat tuntutan beban kerja yang tinggi, jam kerja panjang, serta tekanan emosional dalam praktik klinis. Kondisi burnout yang berkepanjangan dapat berdampak negatif pada kesejahteraan dan kinerja profesional residen. Tujuan: Penelitian ini bertujuan untuk mengkaji tingkat burnout pada residen kedokteran pascasarjana serta menelaah perbedaan burnout berdasarkan karakteristik demografis tertentu. Metode: Penelitian ini menggunakan desain kuantitatif potong lintang dengan melibatkan residen kedokteran pascasarjana dari rumah sakit pendidikan. Pengumpulan data dilakukan menggunakan Maslach Burnout Inventory–Human Services Survey (MBI-HSS). Analisis data meliputi statistik deskriptif dan uji t independen untuk menguji perbedaan dimensi burnout antar kelompok. Hasil: Hasil penelitian menunjukkan bahwa residen mengalami tingkat burnout sedang hingga tinggi, terutama pada dimensi kelelahan emosional dan depersonalisasi, dengan perbedaan yang signifikan pada beberapa variabel demografis. Kesimpulan: Burnout pada residen kedokteran pascasarjana masih menjadi isu penting yang memerlukan perhatian melalui intervensi institusional dan psikologis.

AimSalivary gland neoplasms represent a rare subset of head and neck neoplasms. Due to their varied histological and biological behaviours, they pose a challenge for both surgeons and histopathologists. The study aimed to describe the demographic and clinical characteristics of patients with salivary gland neoplasms at our centre, assess their anatomical distribution and histopathological patterns, and evaluate the concordance of fine needle aspiration cytology (FNAC) with histopathology. The study also documented surgical management approaches, short-term postoperative outcomes, including procedure-specific complications, and the use of adjuvant therapy.Materials and methods A prospective descriptive study was conducted at a single institution for 18 months on 50 consecutive patients diagnosed with primary salivary gland neoplasms. Data were collected by documenting clinical history and performing physical examinations and investigations. After surgery, depending on the histopathological examination reports, radiotherapy was considered. Patients were monitored for three months after surgery. Statistical analyses were conducted using SPSS version 22.0 (IBM Corp., Armonk, NY). Group differences were examined using the chi-square test, with significance set at p<0.05.ResultsIn our study of 50 neoplasms, 38 were classified as benign and 12 as malignant. The 5th decade observed the highest incidence of benign neoplasms, while most reports of malignant neoplasms came from the 4th to 6th decades. In the present cohort, a female preponderance was observed in pleomorphic adenoma, whereas mucoepidermoid carcinoma showed male predominance. FNAC and histopathology agreed in 43 cases, giving an overall diagnostic accuracy of 86.0% and Cohen’s k of ≈0.55 (moderate agreement). In a benign-malignant comparison, FNAC had 100% sensitivity for benign lesions but low specificity (41.7%), indicating reliable detection of benign neoplasms but limited ability to exclude malignancy. Surgery was the main treatment modality in all cases, whereas adjuvant therapy (radiotherapy) was administered in 24% of cases (n=12).ConclusionThe majority of salivary gland neoplasms were benign. Benign neoplasms tended to be more common in females, whereas malignant neoplasms were predominantly observed among males. Pleomorphic adenoma was most prevalent in the parotid gland, and mucoepidermoid carcinoma was most frequently diagnosed in the submandibular gland.

Climate Change is one of the greatest threats faced by the humanity. India is also highly vulnerable to the impacts of Climate Change. In the initial phases of the Global negotiations for Mitigation and Adaptation of Climate Change, India was reluctant to take responsibility for Climate Action. But the decade following 2015, Paris agreement, India has emerged as a responsible actor. India is the only G20 country that is well on track to achieve its goals affirmed in NDC. India has made ambitious targets to be a Net Zero by 2070. This Paper Traces the evolution of India’s Climate Change action Plan and also assesses its strengths and weakness.

In the intensive care unit (ICU), changes in urine color can result from various causes, such as medications, metabolic disorders, and infections, and are always a cause of concern to the treating physician. We managed a polytrauma patient in the ICU and noticed passing green color urine, which was associated with intravenous Propofol administered for sedation. There are various factors that cause changes in urine color. Green color urine induced by Propofol is a rare and remarkable side effect. Propofol metabolites, such as the 4-sulfate and the 1- or 4-glucuronide conjugates of 2, 6-diisopropyl-1, 4-quinol, are excreted in the urine after undergoing glycoconjugation in the liver. The green color of urine is attributed to the presence of these phenolic metabolites in the urine. Phenolic metabolites of Propofol are produced in the liver and excreted in the urine, resulting in a green discoloration. Prompt recognition of this effect can help avoid unnecessary laboratory investigations.

Background Migraine is a leading cause of disability worldwide, often complicated by cervical dysfunction and central sensitization. Non-phamacological strategies such as transcranial direct current stimulation (tDCS) and osteopathic manual therapy show promise, but their combined efficacy remains underexplored. This study aims to evaluate the effectiveness of combining active tDCS with physiotherapy compared to sham tDCS plus physiotherapy in patients with chronic migraine. Methods A single-center, single-blind randomized controlled trial was conducted at Sri Aurobindo University, India. A total of 160 participants with chronic migraine were randomized into two groups: Experimental Group A (Active tDCS + Cranio-cervical osteopathic therapy) and Control Group B (sham tDCS + Cranio-cervical osteopathic therapy). Interventions were delivered over six weeks (18 sessions). The outcomes were pain intensity measured by the Visual Analogue Scale (VAS), headache frequency and duration, pressure pain threshold (PPT), balance (MiniBESTest), quality of life (SF-36), Migraine Disability Assessment Score (MIDAS), Pittsburgh Sleep Quality Index (PSQI), Migraine Symptom Severity Score (MSSS). Statistical analyses employed ANCOVA and linear mixed-effects models with false discovery rate correction. Results Compared with controls, GroupA demonstrated significantly greater reduction in VAS (= 2.10, p &lt; 0 . 001, d = 1.15), headache frequency (∆ = 1.85/week, p &lt; 0 . 001) and duration (∆ =9.45 minutes/day, p &lt; 0 . 001). Significant improvements were also observed in trapezius PPT, balance (+4.30 points, p &lt; 0 . 001), quality of life, dsability and symptom severity. No between-group differences was noted for the sub-occipital PPT, anterior scalene PPT and PSQI. Conclusion Active tDCS combined with physiotherapy provides superior clinical benefits over sham stimulation, reducing migraine intensity, frequency, disability and improving function and qulaity of life. This multimodal approach addresses both central sensitization and peripheral dysfunction, support its role as an effective non-phamacological strategy in migrain management. Trial Registration Enrolled in the International Clinical Trials Registry on December 20, 2021 (CTRI/2021/12/038734). On July 18, 2020, the Sri Aurobindo Institute of Allied Health &amp; Paramedical Sciences’ Research &amp; Ethical Committee gave its approval.

This review explores the evolving world of detecting and handling heart conditions in babiesbefore they're born. It connects traditional ways of predicting a baby's outcome with theexciting new tools of artificial intelligence (AI), along with new, simple tests that aren'tinvasive.Heart defects are a major health issue across the globe, accounting for nearly a third of allserious birth defects. Despite this, routine screenings during pregnancy are still falling short,often failing to catch these problems in non-specialist clinics. When a critical heart issue ismissed, it tragically leads to more newborns getting sick or dying.For years, doctors have relied on a method called the "Cardiovascular Profile" (CVP) score tocheck an unborn baby for heart failure and flag high-risk situations. A CVP score of 7 or loweris a serious warning sign, strongly connected to a higher risk of death.Now, AI offers a fresh approach to solve the problem of scans being dependent on a person’sskill level. It can automatically analyze images and spot difficult patterns with a very highaccuracy rate (over 90%). Beyond that, pairing AI with a simple analysis of a mother's salivaprovides an accurate way to screen for specific, serious heart conditions without invasiveprocedures.However, before making this technology available in public, there are some big hurdles thatshould be cleared. We need to test that all the data used is consistent, we have to get a clearunderstanding of how the decisions are framed by AI (the "black box" problem), and we mustensure it's rolled out in public in such a way that's fair and ethical for every patient.