Background: The suprarenal glands are located retroperitoneally near the posterior abdominal wall at the eleventh—twelfth thoracic vertebrae level. Each gland consists of an outer cortex and an inner medulla. The current study aims to examine the microscopic anatomy of developmental changes in the fetal suprarenal gland in various fetal age groups. Material and Methods: This study was an institution-based observational study conducted in the Department of Anatomy, Thanjavur Medical College, Thanjavur. In this study, 25 dead fetuses with gestational ages ranging from 12 to 32 weeks were obtained from the Obstetrics and Gynecology Department at Thanjavur Medical College. These fetuses were the products of pregnancies that were terminated under the MTP Act of India, 1971. Results: We found that the medulla was poorly characterized between 12 and 16 weeks, while the embryonic suprarenal cortex showed up as two layers: the permanent cortex and the fetal cortex. By the 22nd week, the transitional zone appeared, and the medulla was identifiable. The fetal cortex began to shrink around weeks 22 and 24. By 29 to 32 weeks, zona fasciculata and zona glomerulosa were formed from the permanent cortex's cells. The fetal cortex and permanent cortex have a 1:4 ratio. Throughout the whole development process, this was upheld. Conclusion: Three separate zones—the zona glomerulosa, zona fasciculata, and the fetal zone—could be distinguished in the microscopic examination of the fetal suprarenal gland. This study provides insights into suprarenal gland development, aiding clinicians in understanding conditions like pheochromocytoma and adrenal diabetes. Keywords: Fetal Cortex, Permanent Cortex, Neuroblastic, Nodules, Transitional Zone, Chromaffin Cells.

Background: Cancer remains a major public health concern, with its distribution influenced by demographic, geographic, and lifestyle determinants. Institutional cancer registries provide valuable insights into evolving patterns of malignancy. The present study analyzed site-specific cancer trends, histopathological profiles, and demographic characteristics in a tertiary care teaching hospital over five years. Material and Methods: This retrospective study included all histopathologically confirmed malignancies diagnosed between January 2020 and December 2024. Data regarding age, sex, anatomical site, and histological subtype were retrieved from departmental archives. Frequencies, proportions, and year-wise trends were calculated and summarized in structured tables for analysis. Results: 1,373 malignancy cases were recorded over the five years, with the annual case load rising from 102 in 2020 to a peak of 481 in 2023. Females (52.6%) slightly outnumbered males (47.4%). Oral cavity cancers (27.5%) and breast cancers (21.5%) together accounted for nearly half of the total burden. Cervical (8.0%), colorectal (6.3%), laryngeal (6.0%), skin (5.9%), and thyroid (3.5%) cancers also contributed significantly. Genitourinary, gynecological, lymphoid, soft tissue, and other less common sites formed the remainder of the spectrum. Histopathological evaluation confirmed site-specific patterns: squamous cell carcinoma dominated the oral cavity, cervix, larynx, skin, and penile tumors; invasive ductal carcinoma was the predominant breast malignancy; papillary carcinoma led thyroid cancers; and adenocarcinoma characterized colorectal, gastric, prostatic, and endometrial tumors. Ovarian cancers were chiefly serous, while renal cancers were predominantly clear cell type, and bladder cancers were mostly transitional cell carcinoma. Lymph node biopsies frequently revealed metastatic deposits, with lymphomas representing both Hodgkin and non-Hodgkin subtypes. The majority of cases occurred in the 41–70 year age group, whereas lymphomas and testicular tumors were more common in younger individuals. Conclusion: Oral cavity and breast cancers remain the leading malignancies in this region. The rising trend of gastrointestinal and thyroid cancers highlights the need for regionally tailored strategies, focusing on tobacco cessation, targeted screening, and early detection to reduce overall cancer burden. Keywords: Cancer registry, histopathology, site-specific malignancies, oral cavity carcinoma, breast carcinoma.

Background: Skin is our body’s largest organ and serves functions including protection, immunity, metabolism, sensation, and maintenance of physiological balance. It can be affected by a wide range of conditions, including infectious, inflammatory, and autoimmune disorders. While a detailed clinical history and examination provide valuable diagnostic clues, these are often insufficient alone, necessitating histopathological evaluation aided by special stains and immunohistochemistry. Material and Methods: This retrospective study was conducted in the Department of Pathology, SIMS, Hapur, UP, from January 2024 to December 2024. During this period 150 skin biopsies were received, out of which 50 were diagnosed as hypopigmented lesions and were included in the study. Results: Among the 50 cases of hypopigmented skin lesions, six distinct histopathological patterns were identified, with leprosy and its variants comprising the majority. Conclusion: A comprehensive clinical examination combined with a detailed history can lead to a correct diagnosis in many instances; however, histopathological examination is often indispensable, particularly when clinical findings are inconclusive. Keywords: Hypopigmented lesions, skin, dermatopathology, Leprosy.

Background: Pulmonary tuberculosis (PTB) is frequently associated with hematological abnormalities that may indicate disease severity, guide prognosis, and assist in monitoring therapeutic response. Recognizing these alterations can enhance clinical assessment and patient management. This study aimed to evaluate the hematological profile of smear-positive PTB patients. Material and Methods: This cross-sectional study included 50 newly diagnosed sputum smear–positive PTB patients. Demographic data, complete blood counts, erythrocyte sedimentation rate (ESR), and differential leukocyte counts were recorded. Inclusion criteria were age ≥14 years and sputum smear positivity for Mycobacterium tuberculosis. Patients with extrapulmonary TB, HIV infection, chronic renal or hepatic disease, malignancy, pregnancy, or prior anti-tubercular therapy were excluded. Data were analyzed using descriptive statistics. Results: The highest proportion of patients was aged 36–45 years (26%) and 46–55 years (26%), with a male predominance (70%). Anemia was present in 88.6% of males (<13 g/dL) and 86.7% of females (<12 g/dL), predominantly normocytic normochromic. Leucocytosis (>11,000/cm³) occurred in 70%, neutrophilia (>80%) in 40%, lymphocytopenia (<20%) in 68%, and monocytopenia (<2%) in 30%. Thrombocytosis (>4 lakh/mm³) was seen in 18% and thrombocytopenia (<1.5 lakh/mm³) in 10%. ESR was elevated in all patients. Conclusion: Hematological abnormalities are common in PTB, with anemia, leucocytosis, lymphocytopenia, and thrombocytosis being predominant. These alterations, reflecting the inflammatory nature of TB, may serve as cost-effective adjunctive markers for disease assessment and monitoring. Incorporating routine hematological evaluation into TB management protocols is recommended. Keywords: Pulmonary tuberculosis, anemia, leucocytosis, lymphocytopenia, thrombocytosis.

Background: Mental health is a vital but often overlooked aspect of well-being, especially among non-clinical healthcare workers like General Duty Assistants (GDAs). These workers perform physically and emotionally taxing hospital duties, yet their mental health status is understudied. This study assessed depression and anxiety prevalence among GDAs in a tertiary hospital and explored links with sociodemographic factors. Material and Methods: A cross-sectional study was done at TMMC&RC, Moradabad, from January to December 2024, including all GDAs employed for over a year. Data were collected through structured interviews using standardized tools: Patient Health Questionnaire-9 (PHQ-9), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A). Sociodemographic associations were analyzed using ANOVA. Results: Among 60 GDAs, PHQ-9 scores showed 36.7% had minimal/no depression, 28.3% mild, 25% moderate, 8.3% moderately severe, and 1.6% severe. HAM-D indicated 45% normal, 31.7% mild, 20% moderate, and 3.3% severe depression. On HAM-A, 65% had minimal/no anxiety, 25% mild, 6.7% moderate, and 3.3% severe. Mean scores suggested overall mild depression and anxiety, PHQ-9 = 5.78, HAM-D = 9.08, HAM-A = 9.12. Significantly higher (p<0.05) scores of PHQ-9, HAM-D, and HAM-A scores, are seen in people with rural residence, post-graduates, and the age group 31-40 years. No significant associations were seen with gender and marital status, and PHQ-9, HAM-D, and HAM-A scores. Conclusion: Mild to moderate depression and anxiety are common among GDAs, particularly those from rural areas, higher education, and aged 31–40. Routine mental health screening and support for non-clinical healthcare staff are essential to promote well-being and improve hospital services. Keywords: General Duty Assistants, Depression, Anxiety, PHQ-9, HAM-D, HAM-A, Mental Health, Cross-Sectional Study

Background: Distal femur fractures are complex injuries commonly resulting from high-energy trauma in young adults or low-energy falls in elderly patients. Surgical stabilization with locking compression plates (LCP) has emerged as a reliable option to achieve anatomical alignment, stable fixation, and early mobilization. The objective is to evaluate the clinical, radiological, and functional outcomes of distal femur fractures treated with locking compression plates. Material and Methods: This prospective observational study was conducted on 20 adult patients with displaced distal femur fractures admitted to Government Medical College (SIMS) and Government General Hospital, Ramagundam, between December 2021 and November 2023. Patients were managed with closed or minimally open reduction and internal fixation using LCP. Demographic data, injury characteristics, union time, complications, and functional outcomes were analyzed. Functional assessment was performed using the NEER scoring system at immediate postoperative, 6, 12, and 24 weeks of follow-up. Results: The mean age of patients was 45.7 years, with males predominating (85%). Road traffic accidents accounted for 80% of fractures, and right-sided involvement was more frequent (65%). The majority of fractures were classified as type C2 and C3 (25% each). Union was achieved in most cases within 12–16 weeks, with 70% regaining a range of motion between 80–100°. Functional outcomes improved significantly over time; at 24 weeks, 90% of patients achieved excellent results, and 10% had good outcomes according to NEER scores. Conclusion: Locking compression plate fixation provides stable osteosynthesis, satisfactory union rates, and excellent functional recovery in distal femur fractures, making it a preferred treatment modality. Keywords: Distal femur fracture, locking compression plate, internal fixation, union, NEER score, functional outcome.

Background: Intertrochanteric fractures are one of the most common fractures of the hip more so in the elderly with osteoporotic bones. Morbidity and mortality associated with these fractures are very high if left untreated. Hence surgery is the treatment of choice for such fractures. Internal fixation and early mobilization are currently the standard method of treatment. The objective is to Assess the Functional and Radiological Outcomes of unstable intertrochanteric fractures managed with PFN A-II in elderly patients. Material and Methods: The study was conducted in the Department of Orthopaedics, Shaheed Hasan Khan Mewati Govt. Medical College, Nalhar, Nuh from 1st Sept 2022 to 29th Feb 2024, after due approval from the institutional ethics committee and review board and taking written informed consent from the patients. Results: Majority of cases had TAD value between 20-25mm (53.34%)followed by 10-20 mm (30%), <10mm (10%) and 25-30mm (6.6%). TAD of <25mm is considered satisfactory (93.34% in our study). The mean NSA on the operated side was 124.08±4.48º as compared to normal side 125.26±2.88º with p value of 0.9 which is statistically not significant. Harris Hip Score and it was found that initially HHS was 19.26±2.22, at 2 weeks follow up it was 52.7±6.22, at HHS at 6 weeks it was 65.26±7.21, at 3 months 83.26±7.21, 6 months 85.46±7.19 and 9 months 91.16±5.89. Conclusion: PFN A-II may be a better choice in IT fracture. PFN being a intramedullary load sharing device with a better biomechanical advantage offers biological indirect reduction, concomitantly allowing early mobilization, union rates and weight bearing. Keywords: Functional, Radiological, Outcomes, Unstable Intertrochanteric Fractures, Proximal Femoral Nail A-II, Elderly Patients.

Background: Serous otitis media (SOM), or otitis media with effusion, is a common cause of conductive hearing loss in children. It is often linked to eustachian tube dysfunction and recurrent upper respiratory tract infections (URTI). Early diagnosis and appropriate management are crucial to prevent long-term auditory and developmental sequelae. The objective is to evaluate the demographic profile, clinical characteristics, predisposing factors, and treatment outcomes of serous otitis media in children attending a tertiary care hospital. Material and Methods: A prospective observational study was conducted among 50 children (≤15 years) diagnosed with serous otitis media (SOM). Detailed clinical history, otoscopic examination, pure tone audiometry, and tympanometry were performed for all participants. Based on clinical assessment, patients were managed either medically or surgically, and outcomes were evaluated through improvement in symptoms, normalization of otoscopic findings, and closure of the air–bone gap to less than 15 dB. Results: The mean age of participants was 9.48 ± 2.43 years, with female predominance (56%). Hearing loss (72%) was the most common symptom, and the predominant otoscopic finding was tympanic membrane immobility (92%). The major predisposing factors were recurrent URTI (64%) and adenoid hypertrophy (48%). Type B tympanogram was observed in 64% of cases. Medical management yielded improvement in 48%, whereas surgical intervention achieved a success rate of 94.1% with adenoidectomy and grommet insertion. Younger age and allergic predisposition were significantly associated with better outcomes (p < 0.05). Conclusion: SOM predominantly affects school-aged children and is strongly associated with recurrent URTI. Adenoidectomy with grommet insertion provides the best therapeutic outcome, particularly in younger children and those with allergies. Keywords: Serous otitis media, Eustachian tube dysfunction, Adenoid hypertrophy, Grommet insertion, Hearing loss, Tympanometry, Recurrent URTI.

Background: Sacroiliac joints (SIJs) are frequently implicated in Inflammatory low back pain (ILBP) and are often associated with axial spondyloarthritis. MRI is the gold standard in the early identification of ILBP. However, standard radiography still plays an important role in initial assessment, particularly when resources are limited. To investigate the relationship between radiographic changes in the sacroiliac joints and clinical / laboratory parameters in patients presenting with ILBP, focusing on the relevant use of radiography. Material and Methods: A cross-sectional study took place from January 2024 to August 2025, involving 100 treatment-naive patients aged 18-55 years who met ASAS criteria for inflammatory low back pain. Demographic, clinical, and laboratory data were collected (HLA-B27, CRP, ESR). Bilateral Sacroiliac joint radiographs (AP and oblique views) were graded according to Modified New York criteria (2). Data was analyzed using SPSS v26. Chi-square and t-tests were used to assess associations among variables (p<0.05). Results: The study included 56 male subjects and 44 female subjects (mean age = 33.6 ± 8.9 years). The mean symptom duration was 36.2 ± 24.7 months. Of the total cohort, 89% presented with radiologic sacroiliitis. Of those with sacroiliitis, Grade 2 was present in 40%, Grade 3 in 27%, and Grade 4 in 7%. Of the cohort, 58% presented with symmetric involvement of sacroiliitis. The HLA-B27 antigen was positive in 22% of participants, and there were more positive HLA-B27 results among those with symmetric sacroiliitis (p = 0.03). CRP was elevated in 42% of individuals, with elevated CRP correlated with higher radiological severity (p = 0.01). Conclusion: In the event of limited MRI access, Conventional radiography shows considerable diagnostic utility in patients with chronic ILBP. The association of inflammatory markers with higher sacroiliitis grades underscores the importance of imaging in early evaluation. Awareness among clinicians and early access to radiology services will lead to earlier diagnosis and improved outcomes. Keywords: Inflammatory back pain, sacroiliitis, HLA-B27.

Background: Intradural extramedullary (IDEM) tumors account for nearly two-thirds of spinal tumors and are usually benign, most commonly schwannomas, meningiomas, and neurofibromas. Surgical excision is the primary treatment, with outcomes influenced by tumor type, location, and preoperative neurological status. This study aimed to analyze the clinical, radiological, and histopathological profiles of IDEM tumors and assess surgical outcomes with a focus on neurological recovery. Material and Methods: A prospective observational study was conducted on 35 patients with radiologically confirmed IDEM spinal tumors who underwent surgery between March 2023 and February 2025. Clinical evaluation, MRI findings, and histopathology were analyzed. Neurological function was assessed using the Modified McCormick Scale preoperatively, at discharge, and at six months postoperatively. Results: The mean patient age was 43.5 ± 9.5 years, with a slight female predominance (53.1%). The thoracic spine was the most common site, and schwannomas and meningiomas together comprised 84.4% of cases. Gross total excision was achieved in 87.5% of patients. Postoperatively, there was significant neurological improvement, with 75% of patients achieving McCormick Grade I or II at six months (p < 0.001) with minimal postoperative complications. Conclusion: Microsurgical excision of IDEM spinal tumors provides excellent functional outcomes with low morbidity. Early diagnosis and meticulous surgical technique are key determinants of recovery. Larger multicentric studies with long-term follow-up and use of intraoperative neuromonitoring are warranted to optimize surgical strategies and neurological preservation. Keywords: Intradural extramedullary tumors; Spinal tumors; Schwannoma; Meningioma; Microsurgical excision; Neurological recovery; Modified McCormick Scale; Surgical outcome; Gross total resection.