Teerthanker Mahaveer Medical College & Research Centre

To report a rare case of ovotesticular disorder of sex development (OT-DSD) in a phenotypically male adolescent who presented with bilateral gynecomastia. A 15-year-old phenotypically male child presented with progressive enlargement of bilateral breasts for the past 2years. Clinical examination revealed Tanner stage 4 breast and pubic hair development, unilateral undescended testis, and normal external genitalia. Hormonal evaluation showed low testosterone and raised gonadotropins. Imaging revealed a hypoplastic uterus, fluid-filled vagina, and left-sided ovotestis. Karyotyping confirmed a 46, XX genotype. Clinical, hormonal, and imaging evaluations confirmed the diagnosis of OT-DSD. Because of the established male gender role in his community, he preserved his gender. The patient had liposuction and glandular removal of bilateral breast tissue, as well as left orchidopexy, before being discharged on testosterone replacement treatment. Ovotesticular DSD is uncommon and may manifest in late adolescence with gynecomastia rather than ambiguous genitalia. Clinicians should consider OT-DSD in adolescents who presented with bilateral gynecomastia. Early diagnosis, karyotyping, and multidisciplinary management are crucial to optimize long-term outcomes.

Introduction:The goal of this study was to find out how SGLT2 inhibitors and GLP-1 receptor agonists help persons with Type 2 Diabetes Mellitus (T2DM) keep their blood sugar levels stable.Methodology:There were 120 people in the trial. They were randomly given either empagliflozin, Canagliflozin, Dapagliflozin, Ertugliflozin, Bexagliflozin, Sotagliflozin (an SGLT2 inhibitor) or liraglutide, Sitagliptin, Saxagliptin, Linagliptin, Alogliptin, Vildagliptin (n GLP-1 receptor agonist) to consume for 24 weeks. The major goal was to lower the levels of HbA1c. Some of the secondary outcomes included losing weight, markers of heart health, and adverse events.Results:Both treatments brought down HbA1c levels a lot, although GLP-1 agonists brought them down a little bit more. Both groups’ systolic blood pressure and LDL cholesterol levels improved, but the group that took GLP-1 agonists lost more weight. People who took SGLT2 inhibitors didn’t have as many stomach problems, whereas people who took GLP-1 agonists got nauseated and threw up.Conclusion:The study showed that both types of medicines do a decent job of keeping blood sugar levels steady. But GLP-1 agonists are better at helping people lose weight and keep their hearts healthy, so they are also a fantastic choice for people who have these problems. It’s crucial to consider what each patient needs and what could go wrong while establishing treatment plans for them.

Background: Listening to music has the potential to modify the pacing strategy by positively affecting performance during physical exercise. Objective: To study the effect of music on the pulmonary function performance as well as pulse and blood pressure of the athletes. Methods: This prospective study was conducted in TMIMT College of Physical Education under Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India, between December 2024 and May 2025. A total of 75 participants were enrolled in the study, who were pursuing their third-year graduation in physical education and did exercise regularly at least 3 days a week and whose FEV1/FVC ratio was above 75%. The participants were evaluated for their vital parameters and spirometry at two different points of time. All the participants enrolled in the study had their baseline assessment of pulse, blood pressure and spirometry findings and then they were then subjected to exercise. After exercising their pulse, blood pressure and spirometry were again evaluated. The next session was done on subsequent day and after the initial assessment of all the parameters, the participants were subjected to exercise with synchronized motivational music. After the end of the exercise, their assessment was done. Results: Total exercise duration in whole group with music was slightly greater than exercise duration without music (p<0.05). Significant higher values of maximal heart rate were observed following exercise schedule both with music and without music (p<0.05). There was no significant difference on blood pressure as well as pulmonary function tests, e.g., forced vital capacity, forced expiratory volume in one second, and FEV1/FVC ratio with and without music. Conclusion: To conclude, music increases duration of exercise; it also tends to influence the cardiopulmonary function in athletes. International Journal of Human and Health Sciences Vol. 09 No. 04 Oct’25 Page: 218-222

IntroductionGiant cell tumours (GCT) of the distal tibia are uncommon, locally aggressive lesions that are frequently difficult to manage due to the anatomical and functional intricacies of the region. This case study seeks to elucidate the clinical presentation, surgical procedures, and results in three individuals with distal tibial giant cell tumours, highlighting management and reconstructive techniques in this uncommon location with higher risk of morbidity compared to other locations and to achieve pain free ambulation.Materials and methodsThree cases presenting with localised pain and swelling with painful weight-bearing in the distal tibia, were included in the study. Two patients had primary GCT whereas one had recurrence of the tumour after being managed elsewhere. All patients had biopsy and radiologically proven GCT with differing degrees of local aggressiveness. The management strategy involved wide-margin tumour resection followed by reconstruction techniques including contralateral fibular strut grafting and ankle arthrodesis with cementation and bone graft to restore structural integrity and functionality.ResultsAll three patients underwent successful tumour resection and reconstruction without major intra-operative complications. Radiological assessments confirmed adequate union of grafts and no signs of recurrence during follow-up.ConclusionThis series highlights the efficacy of various modalities for the treatment of GCT of distal tibia. While these methods demonstrate promising results in terms of stability and patient satisfaction, vigilance for recurrence and long-term complications remains critical.

Objective: To detect methicillin-resistant Staphylococcus aureus (MRSA) using the cefoxitin disk diffusion method. The study also determined the minimum inhibitory concentration (MIC) of vancomycin through the broth microdilution (BMD) method and categorized it into vancomycin sensitive-MRSA (VS-MRSA), vancomycin intermediate-MRSA (VI-MRSA), and vancomycin resistance-MRSA (VR-MRSA). All the VS-MRSA strains were screened for heterogeneous vancomycin intermediate-MRSA (hV-MRSA).Material and Methods: In this cross-sectional study, 210 MRSA strains were isolated from the different types of clinical specimens. Vancomycin susceptibility in MRSA isolates was investigated by determining the MIC using the BMD method. We used brain heart infusion screen agar with 4 µg/ml of vancomycin (BHIV4) to screen VS-MRSA strains for hV-MRSA and performed the modified population analysis profile area under the curve (PAP-AUC) method to confirm hV-MRSA.Results: On the basis of MIC determination of vancomycin, out of the 210 MRSA strains, we found 202 VS-MRSA, 7 VI-MRSA, and 1 VR-MRSA. BHIV4 applied and screened 202 VS-MRSA isolates, and these were confirmed with the PAP-AUC method, which revealed 34 hV-MRSA. Conclusion: All MRSA strains identified from the different clinical samples had a prevalence of hV-MRSA, 16.83%. Most of the hV-MRSA detected from the VS-MRSA strains showing the MIC of vancomycin on the borderline (2 µg/ml) indicate that the hV-MRSA is a prior stage of development of VI-MRSA.

Background: The advent of 3D printing in dental implantology offers the potential for more accurate, efficient, and patient-friendly procedures compared to traditional implant methods. This study compares the accuracy, longevity, and patient satisfaction between 3D-printed and traditional dental implants. Objective: To evaluate the performance of 3D-printed dental implants versus traditional methods in terms of accuracy, longevity, and patient satisfaction. Methods: This prospective, randomized controlled trial included 80 participants, divided into two groups: 40 patients received traditional dental implants, while 40 received 3D-printed implants guided by CAD/CAM-designed templates. Accuracy was assessed via CBCT scans, longevity was monitored over 12 months, and patient satisfaction was measured through a structured questionnaire. Data were analyzed using SPSS software, and statistical significance was set at p < 0.05. Results: The 3D-printed group demonstrated significantly better accuracy, with a mean deviation of 0.85 ± 0.22 mm compared to 1.56 ± 0.34 mm in the traditional group (p < 0.001). Implant survival rates were 100% for the 3D-printed group and 97.5% for the traditional group. Patient satisfaction was higher in the 3D-printed group, with a mean score of 9.2 ± 0.5 versus 8.1 ± 0.7 in the traditional group (p < 0.01). Conclusion: 3D-printed dental implants offer significant advantages over traditional implants in terms of accuracy, longevity, and patient satisfaction. These findings support the growing clinical use of 3D printing in dental implantology for enhanced outcomes.

Introduction:Chronic neck pain is a common musculoskeletal condition characterized by persistent pain in the neck lasting more than 3 months. The natural lordotic curvature of the cervical spine can impact the stability of the cervical vertebrae, and alterations to this curvature can lead to neck pain and disability. Our primary objective was to investigate the association of cervical lordosis with neck pain. Secondarily, we also examined the relationship of Cobb’s angle and Jackson physiological stress (JPS) angle with age, gender and BMI.Materials and Methods:This prospective cross-sectional study included 255 adult patients of either gender having neck pain. The patients were stratified into three groups. Neck pain cases without radiation to upper limb were categorised as group I, those with radiation to upper limb as group II and those with neck pain with radiculopathy/ myelopathy as group III. Lateral projection radiograph of cervical spine was obtained for all subjects. Cobb’s angle (C2-C7) & Jackson physiological stress (JPS) angle were measured using DICOM software.Results:Neck pain cases in group I included 93 cases, group II had 98 cases and group III had 64 cases. The mean cervical lordosis as measured by Cobb’s angle was 27.24 ± 9.17 degrees and by JPS angle was 30.65 ± 10.39 degrees (P<0.0001). Both, Cobb’s and JPS angle were similar in all age groups, gender and BMI subcategories (Cobb’s angle: p= 0.631, p=0.156, p=0.61; JPS angle: p=0.396, p=0.0804, p=0.539) respectively. The degree of lordosis was similar in all three pain sub-type when measured by Cobb’s method (p=0.969) or by JPS angle (p=0.952).Conclusion:The study found that cervical lordosis (Cobb’s angle and Jackson physiological stress angle) has no association with cases having neck pain with or without radiation to upper limbs or neck pain with radiculopathy/ myelopathy. Cervical lordosis does not vary significantly with age, gender and BMI irrespective of the method used.

Introduction:Monteggia fracture-dislocations are rare in children can often go undiagnosed, especially when initial treatment is provided by non-specialists. Missed injuries can result in chronic instability, pain, and limited function of the elbow joint.Case Report:We report the case of an 8-year-old girl who sustained an injury to her left elbow after falling while escaping a monkey attack. She initially received only bandaging from a local practitioner and presented to us 1 month later with ongoing pain and restricted elbow movement with posterior interosseous nerve (PIN) palsy. Radiographs revealed a neglected Monteggia fracture-dislocation. She was treated surgically with ulnar osteotomy and fixation with a 3.5 mm dynamic compression plate without reduction of the Radial head. The radial head was found to be reduced after ulnar osteotomy and plate fixation. PIN was not explored. Over a 15-month follow-up, the fracture united well, the radial head remained anatomically positioned, and the patient regained a full range of motion without pain with complete recovery of PIN palsy.Conclusion:This case highlights the potential for Monteggia lesions to be overlooked when not properly assessed at the time of injury. It underscores the importance of early diagnosis and appropriate orthopedic intervention to prevent long-term complications. Even in delayed cases, satisfactory outcomes can be achieved with timely surgical management.

BackgroundBlunt abdominal trauma is a significant cause of morbidity and mortality, particularly in young adults, and accurate imaging is essential for timely diagnosis and management. Computed tomography (CT) is the preferred modality in hemodynamically stable patients, with the routine portal venous (PV) phase protocol commonly employed. Recently, the split-bolus (SB) protocol has been proposed as an alternative, enabling simultaneous arterial and venous phase visualization in a single acquisition. This study compared the image quality, contrast enhancement, diagnostic accuracy, and radiation exposure of the SB protocol versus the standard PV protocol in evaluating blunt abdominal trauma.MethodsA prospective observational study was conducted from September 2021 to August 2022 at Dr. Rajendra Prasad Government Medical College, Kangra. Seventy hemodynamically stable patients with suspected intra-abdominal injury were assigned to SB (n = 35) or PV (n = 35) CT protocols using a non-probability convenience sampling method. Organ and vascular attenuation values were measured in Hounsfield units (HU). Image quality was assessed on a five-point Likert scale, and organ injuries were graded using the Organ Injury Scale (OIS) by two experienced radiologists. Radiation dose metrics included the volume CT dose index (CTDIvol, mGy) and dose-length product (DLP, mGy·cm), which were recorded directly from the scanner console. Effective dose (mSv) was calculated by multiplying DLP by the standard abdominal conversion factor (k = 0.015). Statistical analysis included t-tests, chi-square tests, and weighted kappa statistics for inter-reader agreement, with p < 0.05 considered significant.ResultsThe study population had a mean age of 35.6 ± 13.7 years, with a male predominance (75.7%). Solid organ injuries were identified in 88.6% of cases, most frequently involving the liver (52.9%) and spleen (34.3%). The SB protocol demonstrated significantly higher enhancement in the spleen (141.7 ± 27.8 HU vs. 119.6 ± 19.8 HU, p < 0.001), pancreas (121.7 ± 22.1 HU vs. 99.9 ± 13.6 HU, p < 0.001), and renal cortex (240.6 ± 45.1 HU vs. 179.9 ± 31.4 HU, p < 0.001), while hepatic enhancement was comparable (p = 0.834). Vascular enhancement was consistently superior with SB, particularly in the portal vein, aorta, inferior vena cava, and iliac vessels (all p < 0.05). Overall image quality was rated as good to excellent in both protocols, with no significant difference. Importantly, SB facilitated simultaneous evaluation of arterial and venous injuries and improved urinary tract opacification, reducing the need for delayed scans. Inter-reader agreement for OIS scoring was moderate to substantial (κ = 0.563 for SB; κ = 0.639 for PV). The mean CTDIvol and DLP were comparable between SB and PV groups (CTDIvol: X vs. Y mGy; DLP: X vs. Y mGy·cm, both p > 0.05). The derived effective dose was also similar (8.87 ± 2.85 mSv vs. 8.89 ± 3.05 mSv, p = 0.846).ConclusionsThe SB CT protocol provided superior vascular and parenchymal enhancement compared to the routine PV protocol without increasing radiation exposure. By consolidating arterial and venous phases into a single scan, SB streamlined trauma evaluation, enhanced diagnostic confidence in vascular and urinary tract injuries, and reduced the need for multiphase acquisitions.

Introduction: Surgical removal of impacted mandibular third molars often results in postoperative complications, such as pain, swelling, trismus, and periodontal changes, which can affect patient recovery. The choice of the flap design may influence these outcomes. This study compared the envelope flap and triangular flap with the modified Ward’s incision to minimize postoperative sequelae, focusing on pain, facial swelling, maximum mouth opening, and probing pocket depth, and to provide evidence-based insights for optimizing surgical outcomes in third molar disimpaction.Materials and methods: A prospective comparative study was conducted at the Department of Oral and Maxillofacial Surgery, involving 40 systemically healthy patients (American Society of Anesthesiologists or ASA I or II) aged 18-50 years with mesioangular, distoangular, or vertically impacted mandibular third molars. Patients were assigned to two groups (n=20 each): Group 1 (triangular flap with modified Ward’s incision) and Group 2 (envelope flap). Standardized surgical protocols were followed, with local anesthesia and primary closure using 3-0 silk sutures. Postoperative outcomes such as pain (visual analog scale), maximum mouth opening (interincisal distance), facial swelling (metric facial measurements), and probing pocket depth were assessed on days 1, 3, and 7 and at 3 months. Data were analyzed using independent t-tests and repeated-measures analysis of variance with a significance threshold of p≤0.05.Results: Both groups showed significant improvements in all parameters over time (p<0.001). The envelope flap group had less facial swelling (117.68±6.27 mm on day 1, further reduced by day 7) than the triangular flap group (119.80±5.29 mm on day 1, increased on days 3 and 7). Maximum mouth opening improved faster in the envelope group (21.50±4.47 mm on day 1, significant by day 3) than the triangular group (22.70±5.27 mm on day 1). Pain decreased similarly, from 7.90±0.85 (envelope) and 7.80±0.83 (triangular) to 1.25±0.91 and 1.80±0.83 by day 7, with no notable differences. The probing pocket depth increased temporarily (mean difference = 1.47 mm, p<0.001) but equalized by 3 months (p=0.157). The simpler design of the envelope flap likely reduced tissue trauma and inflammation, enhancing swelling and trismus outcomes.Conclusion: The envelope flap outperformed the triangular flap in reducing postoperative swelling and enhancing early mouth opening recovery, making it preferable for routine mandibular third molar extractions. Both techniques ensured comparable pain control and periodontal healing, supporting their use based on case-specific requirements.