M. P. Shah Medical College

Background: Despite the availability of effective inhaled pharmacotherapy, a substantial proportion of asthma patients fail to achieve optimal disease control. Poor inhaler technique represents a critical yet frequently overlooked barrier to effective drug delivery and clinical outcomes. This study aimed to assess the level of asthma control and evaluate inhaler technique proficiency among adult asthma patients attending outpatient clinics, and to determine the association between inhaler technique errors and asthma control status. Methods: A cross-sectional observational study was conducted across four hospital-based outpatient pulmonology and allergy clinics. A total of 520 adult patients with physician-diagnosed asthma using inhaler devices for ≥3 months were enrolled. Asthma control was assessed using the Asthma Control Test (ACT), and inhaler technique was evaluated through direct observation using device-specific validated checklists. Spirometric assessment, medication adherence (Medication Adherence Report Scale for Asthma, MARS-A), and demographic and clinical variables were systematically recorded. Results: The mean ACT score was 16.8 ± 4.6, with only 34.2% of patients achieving well-controlled asthma (ACT ≥20). Critical inhaler technique errors were identified in 56.7% of participants. The most common critical errors were failure to exhale before inhalation (42.3%), incorrect inspiratory flow rate (38.1%), and failure to hold breath after inhalation (34.6%). Patients with critical errors had significantly lower ACT scores (14.8 ± 4.2 vs. 19.4 ± 3.8, p < 0.001) and lower FEV₁% predicted (68.4 ± 16.2% vs. 78.6 ± 14.8%, p < 0.001). Multivariable analysis identified critical inhaler errors (aOR 3.18, 95% CI 2.14–4.72, p < 0.001), poor medication adherence (aOR 2.64, 95% CI 1.78–3.92, p < 0.001), and absence of prior inhaler education (aOR 2.42, 95% CI 1.62–3.61, p < 0.001) as independent predictors of uncontrolled asthma. Conclusion: The majority of asthma patients in outpatient settings demonstrate suboptimal disease control, with critical inhaler technique errors affecting more than half of users. Inhaler technique proficiency is independently and strongly associated with asthma control status. Systematic assessment and regular reinforcement of inhaler technique should be integrated into routine asthma management.

Background: Chronic plaque psoriasis is a systemic immune-mediated inflammatory dermatosis characterized by dysregulated cytokine networks and persistent cutaneous inflammation. Serum inflammatory biomarkers have emerged as potential objective indicators of disease activity, yet their precise correlation with clinical severity indices remains incompletely characterized. Methods: This cross-sectional study enrolled 120 patients with chronic plaque psoriasis and 60 age- and sexmatched healthy controls from the dermatology outpatient department of a tertiary care hospital. Patients were stratified into mild (PASI <7), moderate (PASI 7–12), and severe (PASI >12) groups. Serum biomarker levels were quantified using enzyme-linked immunosorbent assay (ELISA). Correlations between biomarker levels and PASI scores were analyzed using Spearman's rank correlation coefficient. Results: Mean serum levels of CRP (14.82 ± 6.41 mg/L vs. 2.14 ± 1.03 mg/L; p<0.001), IL-6 (28.67 ± 11.54 pg/mL vs. 5.23 ± 2.18 pg/mL; p<0.001), TNF-α (45.39 ± 18.72 pg/mL vs. 8.91 ± 3.44 pg/mL; p<0.001), and IL17A (38.56 ± 14.83 pg/mL vs. 6.47 ± 2.76 pg/mL; p<0.001) were significantly elevated in psoriasis patients compared to controls. All biomarkers demonstrated significant positive correlations with PASI scores, with IL17A exhibiting the strongest correlation (r=0.784, p<0.001). Conclusion: Serum inflammatory biomarkers are significantly elevated in chronic plaque psoriasis and correlate positively with disease severity. IL-17A demonstrated the strongest association with PASI, supporting its utility as a reliable serological indicator of disease activity and therapeutic monitoring.

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with significant morbidity through micro- and macrovascular complications. Serum uric acid (SUA) has emerged as a potential biomarker linked to glycaemic dysregulation, dyslipidaemia, and early renal impairment. Despite its clinical relevance, SUA levels in T2DM patients remain understudied in the Indian context, particularly in Gujarat. Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital, Pramukh Swami Medical College, Karamsad, and enrolling 200 participants: 100 T2DM patients and 100 age-sex–matched healthy controls. Biochemical parameters including fasting plasma glucose (FPG), HbA1c, serum uric acid, lipid profile, serum creatinine, and urine albumin-to-creatinine ratio (UACR) were measured. Statistical analysis was performed using Epi info version 7. Results: Serum uric acid was significantly elevated in T2DM patients (6.43 ± 1.19 mg/dL) compared to controls (4.84 ± 0.99 mg/dL; p<0.001). Hyperuricaemia was present in 34% of diabetic patients versus 8% of controls. SUA correlated positively with triglycerides (r=0.46), FPG (r=0.34), HbA1c (r=0.29), and UACR, and negatively with HDL-C (r=−0.31). ROC analysis revealed SUA >6.2 mg/dL as the optimal cut-off for predicting albuminuria (AUC=0.76; sensitivity 72%, specificity 68%). Conclusion: Serum uric acid is significantly elevated in T2DM patients and independently correlates with atherogenic dyslipidaemia and early renal damage. Routine SUA monitoring may serve as an accessible and costeffective biomarker for cardiorenal risk stratification in diabetic populations.

Godan is a picture of Indian agrarian society where the interplay of power, culture and social hierarchy has been depicted.Munshi Premchand has drawn the various aspects of rural India in the novel.The analysis of the novel's incidents and occurrences reveals the power dynamics, class, gender, caste, culture, and belief system of the society.It depicts the struggle of Hori, the rebellious nature of Gobar, the exploitation of Selia, the dogmatic nature of Rai Saheb, the western values of Malti, the philosophical tone of Mr Mehta and many more aspects of the rural and urban culture.The present paper studies the novel as a perfect mosaic of cultural studies, as it shows the diverse aspects of the culture within the fabric of rural and urban society.The lifelong struggle of Hori exemplifies the hegemonic power of the culture where the economic, cultural and social aspects of the society have been dominated by the upper caste and elite class.It reveals the hegemony of culture and ideologies which largely govern the lives of the characters.

Abstract Background : India’s health system is burdened by high out-of-pocket spending and limited insurance coverage, which hinder progress toward Universal Health Coverage (UHC). In September 2025, the 56th Goods and Services Tax (GST) Council introduced reforms eliminating GST on health and life insurance premiums and reducing tax rates on medicines and devices. These changes have implications for financing, equity, and Sustainable Development Goals (SDGs). Objective : To examine the potential impact of the 2025 GST reforms on healthcare affordability and UHC in India. Methods : Policy documents, government press releases, and peer-reviewed literature were reviewed, with focus on financial protection and service coverage dimensions of UHC. Findings : Removal of GST on insurance premiums lowers household spending and may increase coverage, though withdrawal of input tax credits poses risks. Reduced GST on medicines (0–5%) and devices (5%) is expected to improve affordability and expand service coverage. Reforms align with SDG 3.8 (UHC), SDG 1 (No Poverty), and SDG 10 (Reduced Inequalities). Concerns include fiscal sustainability and pass-through of benefits. Conclusion : GST reforms act as a fiscal lever advancing UHC in India. Their long-term success depends on regulation, monitoring, and integration with public health financing strategies.

ABSTRACTAim:Present study evaluates the impact of different regional FSTT datasets on the accuracy of computerized forensic facial reconstructions in a contemporary Indian context.Material and Method:A 40-year-old Indian man’s CT image was converted into a 3D skull model in InVesalius 3.1. Geomagic Freeform Plus (2022.1.31) and Touch X hardware sculpted facial reconstructions. Use FSTT values from Gujarati, North Indian, and South Indian datasets to place landmark-specific soft tissue markers. RMS error and color-coded deviation maps were calculated by comparing each generated face to the subject’s facial surface to assess reconstruction accuracy.Result:Quantitative research showed the South Indian model has the lowest RMS error (3.351 mm), followed by North Indian (3.754 mm) and Gujarati (4.376 mm). This suggests population matching increases geometric integrity. The population-matched model had less error for the highest orbital and cheek deviations in qualitative assessments with consistent error patterns.Conclusion:Population-specific soft-tissue reference data significantly enhance the anatomical accuracy of forensic facial reconstruction. Comprehensive regional FSTT databases and advanced digital modeling are recommended for reliable human identification. Persistent data gaps and anatomical variability highlight the need for ongoing research.