Jawaharlal Nehru Medical College Hospital

Autism spectrum disorder (ASD) is a neurodevelopmental disorder increasingly diagnosed in early childhood. Concurrently, screen time exposure among young children has risen, prompting global concern. Understanding the potential association between early screen exposure and ASD risk is vital for informing parental guidance and policy. A narrative review was conducted using electronic databases including PubMed, Scopus, and Google Scholar. Studies published between 2010 and 2024 that assessed screen time exposure in children under five and its association with ASD or ASD-like symptoms were included. The review considered observational studies, meta-analyses, and systematic reviews. Socio-economic status, parental education, and urban-rural differences were evaluated as confounding factors where data allowed. Most studies indicated a potential association between excessive screen time (particularly passive screen use beyond 2 hours per day) and ASD-like symptoms or delayed verbal communication in children under five. However, the evidence remains inconclusive due to variability in study designs and measurement tools. Socio-economic background emerged as a significant moderator, with children from lower-income families showing higher screen exposure and reduced interactive parenting. While excessive screen time may be associated with ASD-related developmental concerns, causality cannot be established due to potential confounders. Public health interventions should focus on promoting balanced screen use and parent-child interaction, especially in socio-economically disadvantaged settings. Further longitudinal research is needed to clarify causation and guide early intervention strategies.

Abstract Background: Group B Streptococcus (GBS) is a significant but underrecognized cause of stillbirth, particularly in low-and middle-income countries (LMICs) such as India, where diagnostic and surveillance practices remain limited. Aim: To estimate the prevalence of maternal GBS colonization and its correlation with fetal infection and placental histopathology. Methods: This cross-sectional study was conducted over 24 months at a tertiary carecenter. Maternal rectovaginal swabs and fetal samples(cord blood, lung aspirate) from 102 stillbirths (≥28 weeks or ≥1000 g) were cultured for GBS. Placental tissues were examined histologically. Associations were analyzed using chi-square and logistic regression. Results: Maternal GBS colonization was detected in 17.6% of stillbirth cases. GBS was isolated from 11.8% of amniotic fluid, 7.8% of cord blood, and 4.9% of lung aspirates. A significant maternal–fetal concordance was observed, with GBS-positive mothers showing 5.3 times higher odds of fetal GBS detection (p = 0.001). Placental inflammation was significantly more common in GBS-positive cases (p < 0.001). Conclusion: GBS is a major, yet often overlooked contributor to stillbirths, with strong maternal–fetal transmission and associated placental pathology. These findings emphasize the need for routine GBS screening during pregnancy and consideration of preventive strategies, including maternal GBS vaccination and the development of national screening guidelines, to reduce preventable stillbirths in low-resource settings.

Objectives: To compare the incidence of postoperative delirium between on-pump and off-pump adult cardiac surgery patients receiving standardized midazolam induction. Material and Methods: Prospective observational study including 100 adults (50 on-pump, 50 off-pump). All patients received midazolam 0.05 mg/kg IV during induction. Post-operative delirium (POD) was assessed using CAM-ICU at 6, 12, 24, and 48 hours postoperatively. Results: POD incidence was 16% in on-pump and 12% in off-pump patients (P = 0.57), showing no statistically significant difference. Conclusion: Short-term peri-induction midazolam use did not significantly influence POD incidence, supporting its safety when used briefly in adult cardiac surgery.

The preferred technique for femoral implant sizing in primary total knee arthroplasty (TKA) is debatable. Sizing is based on the anterior femoral cortex or posterior condylar reference. Using a single knee system, this study compared anterior referencing (AR) versus posterior referencing (PR) in patients undergoing simultaneous bilateral TKA, where one reference technique was randomized to each knee. This prospective study compared the two sizing references using one posterior stabilized knee system. The study included 81 subjects with osteoarthritis and similar varus deformity in both knees. All subjects underwent identical surgical procedures, aside from the selected femoral sizing reference. Subjects were followed for at least 2years. The two sizing techniques did not significantly differ in all measured radiographic, operative, and clinical parameters. The mean posterior condylar offset ratios were similar. Two-year mean knee flexion and Revised Oxford Knee Scores showed no difference. Eighty-four percent of patients stated no preference for either technique. Knees sized with anterior referencing had similar functional outcomes to those sized with posterior referencing. Using a current knee system with multiple sizing options, there is no discernable difference in all measured study parameters. Either reference is acceptable.Level of Evidence 2 (Randomized cohort study).

ABSTRACTBackground:Menstruation is a natural physiological process, yet it continues to be surrounded by cultural silence and misconceptions in many communities. Poor menstrual hygiene and lack of awareness contribute to a range of health complications, including reproductive tract infections and psychosocial challenges. While studies on adolescent girls are common, research focusing on college-going young women aged 19–25 is relatively scarce.Objective:To assess menstrual perceptions, practices, and awareness of premenstrual syndrome (PMS) among college students in Chandigarh, and to identify gaps in menstrual health knowledge and hygiene behavior.Methods:A cross-sectional descriptive study was conducted among 100 female college students aged 19–25 years in Chandigarh using a pretested structured questionnaire. Data were analyzed using SPSS, with Chi-square tests applied to assess associations.Results:Although 72% had premenarche knowledge and 98% used sanitary pads, only 33% changed them ≥ 4 times/day, and just 25% used soap and water for perineal hygiene. PMS awareness was low (52%), despite a high prevalence of related symptoms. Cultural restrictions were commonly reported, including food taboos and limited communication with male family members. A significant association was found between premenarche knowledge and menstrual hygiene practices (P = 0.022), and between perception and practice (P = 0.013). Overall, 78% had poor perception scores, and 82% practiced suboptimal hygiene.

Imatinib is a tyrosine kinase inhibitor used to treat chronic myeloid leukemia. Inhibition of c-kit causes melanocyte dysfunction, thereby leading to dermatological side effects. It causes various skin side effects and hypopigmented rash being common. We report a rare case of a hyperpigmented rash of Imatinib.

Background Neonates, particularly those born preterm, undergo multiple painful procedures in neonatal intensive care units (NICUs). Evidence shows that such exposures are not transient but induce long-lasting neuroimmune and epigenetic changes, creating a phenomenon termed “pain memory,” with effects on brain development and behavior. Methods This scoping review was conducted using a PICOT framework. Population: neonates (preterm and term); Intervention: procedural or surgical pain and its management (pharmacological and non-pharmacological); Comparator: infants with lower/no pain exposure or alternative management; Outcomes: (a) biological mechanisms, (b) neurodevelopmental and behavioral sequelae such as anxiety and dysregulation, (c) demographic/sex-specific differences, (d) clinical management strategies; Timeframe: immediate to long-term follow-up. Searches of PubMed, Embase, Web of Science, Scopus, and Cochrane (1990-May 2025) identified 342 records. Following duplicate removal, 270 abstracts were screened, 90 full texts were reviewed, and 30 studies were included. Screening was performed independently by two reviewers, with conflicts resolved by a third adjudicator. Data were charted for design, demographics, interventions, outcomes, and limitations. Results Studies have revealed that early nociceptive injury primes microglia and reprograms macrophages through epigenetic pathways. Clinical cohorts showed cumulative pain exposure associated with altered thalamic/cortical development, reduced white-matter integrity, lower cognitive scores, and higher risks of anxiety and behavioral dysregulation. Females exhibited stronger immune-mediated programming, while extremely preterm infants were most vulnerable. Non-pharmacological strategies (skin-to-skin, breastfeeding, sucrose), alongside judicious pharmacological use, reduced acute pain and may influence long-term outcomes. Conclusions Neonatal pain memory represents durable biological and behavioral alterations. Multimodal, family-centered approaches should be standard, while future trials must clarify whether early interventions reduce later neurodevelopmental risks and how sex-specific mechanisms can inform personalized care.

ABSTRACTContext:Psychiatric disorders are common among people with diabetes but often go undiagnosed and untreated. Various factors increase the risk of mental disorders in diabetic patients.Aims:1. To estimate the prevalence of psychiatric disorders among adult patients with type II diabetes mellitus. 2. To identify sociodemographic factors associated with psychiatric comorbidity in the study population.Settings and Design:The present cross-sectional study was conducted under the Department of Community Medicine, JNMC (2023–2024), among the 390 randomly selected type II diabetes mellitus patients.Methods and Materials:Study tools included a predesigned structured questionnaire for collecting data on sociodemographic factors. The General Health Questionnaire (GHQ-12) was used to screen psychiatric disorders, and Diagnostic and Statistical Manual of Mental Disorder 5 Text Revision (DSM-5 Level 1) was used to confirm different psychiatric disorders.Statistical Analysis Used:Data were analyzed using IBM SPSS 20.0 software. For assessing the association of psychiatric disorders with sociodemographic factors, binary logistic regression was applied.Results:Among 390 patients, 177 (45.4%) were males and 213 (54.6%) were females, with a mean age of 56.49 ± 12.49 years. Psychiatric disorders were present in 120 (30.8%) patients, among which depression (27.6%) and anxiety (23.5%) were most common. Psychiatric disorders were more common in patients above 70 years of age, females, living alone, illiterate, presently not working, belonging to the Muslim faith, patients residing in semiurban areas, patients belonging to a 3-generation family, and the upper socioeconomic class. Significant associations were found between the presence of psychiatric disorders and gender, marital status, educational status, and occupational status.Conclusions:Psychiatric comorbidity is common among patients with type 2 diabetes. Sociodemographic factors such as gender, marital status, level of education, and occupational status are important determinants of psychiatric comorbidity among diabetic patients.