Background: Adolescence is a critical period of physical and cognitive development, during which nutritional status may influence academic performance. Body Mass Index (BMI), as an indicator of nutritional status, has been increasingly studied for its potential association with scholastic achievement. However, the relationship remains inconclusive, particularly in developing countries experiencing a dual burden of malnutrition. The objective is to estimate the relationship between academic performance and BMI among adolescents. Material and Methods: The cross-sectional study was conducted on 474 students aged 13-18 years, comprising both males and females. Anthropometric data (height and weight) were collected to calculate BMI, which was ranked according to standard values. Grade Point Average (GPA) and subject-specific scores from school records were used as measures of academic performance. Data on socioeconomic status and lifestyle were also obtained. Appropriate tests were used for statistical analysis, and a p-value below 0.05 was considered significant. Results: The mean age of the participants was 15.62, 1.42, which is equivalent to 15.62 in accordance with the sample size. The mean BMI was 21.84 ± 5.36 kg/m². Among students with normal BMI, academic performance was slightly better than that of underweight and overweight/obese students, but the differences were not statistically significant (p>0.05). Conclusion: BMI was not a significant independent predictor of scholastic achievement in adolescents. Socioeconomic, lifestyle, and environmental factors appear to combine to influence academic achievement. Keywords: Body Mass Index; school achievement; Adolescents; GPA; Nutrition; Lifestyle Factors.

Background: Meibomian Gland Dysfunction defined as “a chronic and diffuse anomaly of Meibomian glands, commonly characterized by obstruction of the terminal duct and /or qualitative or quantitative changes in glandular secretion. According to DEWS II workshop, diabetes is one of the risk factor for dry eye and the symptoms are more in diabetic than in non-diabetic population. The aim is to determine the association between the different levels of dyslipidemia and severity of Meibomian gland dysfunction in diabetic patients. Material and Methods: This is a cross-sectional analytical study from November 2019 to May 2021 comprising of 84 individuals with diabetes who have dysfunctional meibomian glands. Fasting serum lipid profile was done. Results: Total number of patients who belonged to stage 1 MGD was 24, stage 2 was 29, stage 3 was 16 and stage 4 was 15. Stage 2 had the greatest number of patients (n=29, 34.5%), whereas stage 3 had the fewest patients (n=15, 17.9%). Maximum number of patients with LDL cholesterol >130 mg/dL belonged to stage 3. Maximum number of patients with HDL cholesterol 40 mg/dL or less belonged to stage 4. Maximum number of patients with Triglyceride levels > 150mg/dl belonged to stage 4. The largest group of patients in our study (n = 29) were in stage 2, whereas the smallest group (n = 15) were in stage 4. Given the significance of the P value, there is a correlation between rising MGD stage and rising lipid profile component values. Conclusion: There is a strong association between severity of MGD and the level of dyslipidemia in the blood. As the lipid levels increases in the body, the severity of MGD increases. Keywords: Meibomian gland dysfunction, dyslipidemia, dry eyes.

Background: Trigger finger (stenosing tenosynovitis) is a common condition characterized by painful locking or snapping of the affected digit due to thickening of the A1 pulley and flexor tendon inflammation. Surgical release of the A1 pulley is considered the gold standard for cases refractory to conservative management. This study evaluates clinical outcomes following open surgical release of the A1 pulley in 36 patients. Material and Methods: A prospective observational study was conducted on 36 patients diagnosed with trigger finger and treated with open A1 pulley release between January 2023 and December 2025 at Government Medical College Rajouri. Patients were evaluated using Quinnell grading, Visual Analogue Scale (VAS) for pain, and range of motion (ROM) preoperatively and during follow-up at 2 weeks, 6 weeks, and 3 months postoperatively. Results: The mean age was 47.8 ± 10.4 years, with female predominance (61%). The thumb was the most commonly involved digit (44%), followed by the ring finger (28%). Complete resolution of triggering was achieved in 94.4% of patients. Mean VAS score improved significantly from 6.8 ± 1.1 preoperatively to 0.9 ± 0.6 at 3 months (p < 0.001). Minor complications were observed in 2 patients (5.5%), including superficial wound infection and transient stiffness. No recurrence was observed during follow-up. Conclusion: Open surgical release of the A1 pulley is a safe, effective, and definitive treatment for trigger finger, demonstrating high success rates and minimal complications in the present study. Keywords: Trigger finger, Stenosing tenosynovitis, A1 pulley release, Hand surgery, Surgical outcomes.

Background: Bacterial sepsis is a severe, life-threatening illness caused by bacterial infection, which creates an abnormal immune response and results in damage to many different organ systems in the body. Many researchers have demonstrated that oxidative stress significantly contributes to the development of sepsis. During systemic inflammation, excessive reactive oxygen species (ROS) are produced, leading to oxidative damage to lipids, proteins, and DNA, as well as a loss of the body's natural ability to produce protective antioxidants. Testing for oxidative stress markers can help determine how severe and advanced the disease is and may provide information for developing future treatments. In this study, the authors examined how people with sepsis differ from healthy individuals in terms of blood oxidative stress levels. They also wanted to see whether there were any links between these findings and a patient's illness severity. Material and Methods: An analysis was conducted using a prospective case-control design over 18 months, with 120 subjects participating. Of these subjects, 60 comprised the study group, consisting of patients who met clinical and laboratory criteria for bacterial sepsis. At the same time, the other 60 were healthy individuals who were matched for age and gender and were free of chronic systemic illness or any evidence of infection. To evaluate oxidative stress levels in their bodies, blood samples were taken from all participants. In addition to measuring levels of malondialdehyde (MDA), a biochemical marker of lipid oxidation (lipid peroxidation), catalase, superoxide dismutase, and reduced glutathione, statistical comparisons were made between the two groups. Results: Bacterial sepsis patients show significantly higher malondialdehyde concentration than healthy controls, suggesting an increased level of lipid peroxidation. Bacterial sepsis patients exhibit significantly lower levels of key antioxidant markers (superoxide dismutase, catalase, and reduced glutathione), indicating an impaired endogenous antioxidant defense system. Thus, these results indicate a significant imbalance between oxidative and antioxidant systems in bacterial sepsis. Conclusion: Increased levels of oxidative stress and impairment of the ability to provide antioxidant protection against this increased oxidative stress will occur during bacterial sepsis. Thus, monitoring levels of oxidative markers could provide insight into how this disease progresses and may be used to develop different therapeutic strategies based on antioxidant therapies. There is also a need for further research to evaluate the prognostic significance of oxidative markers in patients with sepsis. Keywords: Bacterial sepsis; Oxidative stress; Malondialdehyde; Superoxide dismutase; Catalase; Glutathione; Antioxidant defense; Reactive oxygen species.

Background: Varicose veins represent a common manifestation of chronic venous disease affecting the lower limbs and are associated with considerable morbidity when left untreated. Although often considered benign, complications such as pigmentation, dermatitis, thrombophlebitis, and venous ulceration may significantly impair quality of life. The present study aimed to evaluate the demographic profile, clinical characteristics, and management outcomes of patients presenting with varicose veins at a tertiary care teaching hospital. Materials and Methods: This hospital-based observational study was conducted in the Department of General Surgery at a tertiary care centre over a period of 24 months. A total of 85 patients diagnosed with primary varicose veins were included. Data regarding demographic characteristics, clinical presentation, venous involvement, complications, and surgical management were collected and analysed using descriptive statistics and Chi-square testing. Results: Females constituted the majority of patients (83.5%). The most commonly affected age group was 21–30 years (24.7%). Left lower limb involvement was observed in 49.4% of cases. Farmers represented the predominant occupational group (44.7%). Pigmentation was the most frequent complication (30.6%). Surgical management yielded favourable outcomes, with seroma being the most common postoperative complication (11.8%). Conclusion: Varicose veins predominantly affect young and middle-aged individuals engaged in occupations involving prolonged standing. Early diagnosis and appropriately tailored surgical intervention result in satisfactory clinical outcomes with minimal complications. Preventive public health strategies addressing occupational risk factors are essential to reduce disease burden. Keywords: Varicose veins; Chronic venous disease; CEAP classification; Duplex ultrasonography; Saphenofemoral junction; Surgical management; Occupational risk factors

Background: Objective: 1. To compare the results of type-1 tympanoplasty by transcanal underlay technique in wet and dry ears in mucosal COM, 2. To study the histopathological changes (vascular status) in tympanic membrane remnants in wet and dry ears. Material and Methods: The current prospective study was conducted at a tertiary care facility in Haryana, in the departments of pathology and otorhinolaryngology. The research included 40 patients with mucosal chronic otitis media (COM) of either sex aged 18 to 50. Two groups of patients were created. Twenty consecutive individuals with moist ears made up Group 1. Twenty consecutive individuals with dry ears who had not used topical or systemic antibiotics for at least 6 weeks comprised Group 2. Type 1 tympanoplasty was performed in all patients after written informed consent. Pre-operative CT scan was done in the patients who had mucoid discharge to rule out mastoiditis. The study's findings were evaluated based on graft uptake and hearing gain. Results: The overall graft take-up rate in group 1 was 85%, while that in group 2 was 80% and was thus statistically comparable (p > 0.05). The hearing gain in group 1 was 15.39 dB, and in group 2, it was 14.77 dB; therefore, comparable and showing no statistical difference. Conclusion: Patients with mucoid ear discharge who have not responded to adequate medical treatment can be taken up for surgery; there is no need to postpone the procedure in such cases. The condition of the treated ear is less important to the surgical outcome than careful surgical technique. Keywords: Chronic otitis media; mucosal; tympanoplasty; histopathology; neovascularisation.

Background: Pleural effusion is a major clinical dilemma in resource-constrained countries, especially in tribal communities, where tuberculosis is still endemic. Proper diagnosis is crucial for management, and therefore, the standard diagnostic approach may not be very useful in these societies. Material and Methods: A prospective observational study design was used to conduct the research, recruiting 81 straight patients with proven pleural effusion from tribal communities over 18 months. Through a complete clinical assessment, biochemical examination, and molecular tests were conducted. The parameters of diagnostic accuracy, such as sensitivity, specificity, positive predictive value, and negative predictive value, were estimated on ADA and TRUNAT. Results: The respondent population was clearly male-dominated (62.5), with a mean age of 42.3 and a standard deviation of 11.8. The most common etiology was tuberculous effusion (65.4%), followed by parapneumonic one (21.0%). ADA had a sensitivity 94.3% and a specificity 60.7% with a cutoff of 40 IU/L, and TRUNAT had a sensitivity of 39.6% and a specificity of 82.1%. The outcomes of the two tests, combined, achieved better diagnostic accuracy (AUC 0.89). The correlations between lymphocyte predominance and ADA levels (r=0.45, p=0.001) and TRUNAT positivity (r=0.38, p=0.004) were significant. Conclusion: Tuberculous pleural effusion is the most widespread cause of exudative effusion in tribal people. ADA shows better sensitivity, whereas TRUNAT has good specificity, suggesting complementary diagnostic applications in resource-constrained hospitals. Keywords: Pleural effusion, TB pleurisy, AD, TRUNAT, tribal population, diagnostic accuracy.

Background: The method of spinal anaesthesia is selected when dealing with most proctological operations. The midline mode is conventionally a good choice, whereas the paramedian mode is often used in patients whose anatomy is difficult to locate. The objectives are to compare patient acceptance, comfort, proximal characteristics, and postoperative outcomes between the paramedian and midline techniques of spinal anaesthesia in patients undergoing elective anorectal surgery. Material and Methods: Within an anorectal surgery case study, 80 patients were asked to receive spinal anaesthesia between January and December 2025, which compared the patient acceptance, comfort, characteristics of the procedure, and postoperative outcomes between paramedian and midline methods. Two groups of patients were used (Group M, n=40) (midline approach) and (Group P, n=40). Patient acceptance was measured using a structured questionnaire and a visual analogue scale (VAS) for pain during needle insertion. Secondary outcome measures included the number of attempts, ease of landmark identification, time to a successful block, complications, and general patient satisfaction with the treatment, which showed significant differences between the paramedian and midline groups (p<0.05). The paramedian method required fewer attempts and had lower VAS pain scores. Response to study questions: Group P had a lower incidence of post-dural puncture headache and backache, although the difference was statistically insignificant. Results: Patient acceptance and satisfaction scores were significantly higher in the paramedian group compared to the midline group (p<0.05). The paramedian approach required fewer attempts and was associated with lower VAS pain scores. Incidence of post-dural puncture headache and backache was lower in Group P, though not statistically significant. Conclusion: Group P had a lower incidence of post-dural puncture headache and backache, but the difference was not significant compared with the midline approach in proctology surgeries, making it a worthy alternative, particularly in patients with problematic spinal anatomy. Keywords: Spinal anaesthesia, Paramedian approach, Midline approach, Patient acceptance, Anorectal surgery.

Background: ADS is a major community health issue in India, which results in a lot of medical, psychological, and social morbidities. Age, level of education, occupation, socioeconomic status, family setup, and early alcohol consumption pursuits are socio-demographic aspects that play a paramount role in the development and progression of alcohol dependence. Knowing the socio-demographic profile of patients with ADS is necessary to identify high-risk groups and determine how the intervention (preventive or therapeutic) can be planned effectively. The objective is to research the socio-demographic characteristics of patients who turned up in a tertiary care hospital with a diagnosis of alcohol dependence syndrome. Material and Methods: It was a cross-sectional observational study conducted over 18 months at a teaching tertiary care hospital in India. A sample of 100 patients who had a clinical diagnosis of alcohol dependency syndrome based on the ICD classification was selected to take part in the study upon informed consent. The socio-demographic variables, such as character of age, education, occupation, domicile, socioeconomic status, religion, marital status, type of family, and family history of alcoholism, were evaluated using a semi-structured pro forma. The data were analysed using descriptive statistics. Results: Most patients were aged individuals in the economically productive segment, with middle-aged individuals predominating. The vast majority of participants had an education up to primary or secondary school level and remained in unskilled or semi-skilled professions. The majority of the patients were of lower and lower-middle socioeconomic classes. There was a higher prevalence of alcohol dependence among people who were in nuclear families, and a high proportion had a positive family history of alcoholism. It was common among the study subjects to start drinking at an early age. Conclusion: The results suggest that alcohol dependence syndrome is associated mostly with individuals who belong to the socio-demographic background of vulnerability. The age at which it is initiated and the family alcoholism history seem to be among the factors that may be significant. The discovery of such socio-demographic determinants is vital to the formulation of specialized prevention measures and the enhancement of de-addiction facilities at the community and tertiary care levels. Keywords: Alcohol addiction; demography; tertiary care hospital; cross-sectional study; substance use problem.

Background: A neurologist treating a case of pain abdomen is quite a surprise to many!! But scarcely, it may happen like that. It is because the disease porphyria can present to the Department of Neurology with neuropathy and can at times present with recurrent pain abdomen as well. In such cases, neurogenic inflammation leads to pain abdomen. This pain in the abdomen can be misdiagnosed initially by clinicians and treated symptomatically. However, it is of prime importance to diagnose this entity early because, with each bout of attack, neuropathy progresses. Again, certain drugs must be avoided as they can precipitate acute attacks. We present here a case of a young lady with recurrent pain abdomen who was treated by multiple gastroenterologists symptomatically and finally turned out to be a case of porphyria. Keywords: Neurogenic Pain Abdomen, Porphyria, Recurrent Pain Abdomen.