‘In past 20 years, the world has made notable gains in the health of women and girls. Still, 800 women die each day due to preventable complications of pregnancy and childbirth. On #WomensDay, we reiterate our commitment to address the root causes of women’s and girl’s health disparities’. -Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, 8 March 2023.[1] Dear Editor, Dhinwa et al. conducted a study to detect associated risk factors for pregnancy-induced hypertension (PIH) in rural areas of Dehradun district and got the results published in January – March 2025 issue of the Journal.[2] The authors made a painstaking work of surveying pregnant women in hard-to-reach areas, collecting their socio-demographic profile, obtaining relevant obstetric history along with medical one. They also gained access to factors associated with the disorder and afterwards computed the relationship of quantitative variables of hypertensive subjects. Multiple logistic regression calculated on the basis of the variables shows predictive factors of PIH among the cohort. 7 tables of the article generate a brief overview of the survey and abbreviate all the key points. The insight provides us to make an early identification of at-risk groups so as to put them under heightened surveillance. We need more such studies, as this is one of the most common causes of maternal morbidity and mortality nowadays.[3] Timely control of risk factors after identification helps healthcare workers to reduce the burden of the disease. Nonetheless, when I went through the study, I found a few discrepancies where I want to draw the authors’ attention. Table 1 of the article classifies study subjects on the basis of their religion. And most of them are Hindus (98%). But the census of India shows that close to 14% of the population of the hilly State is Muslim.[4] Why were Muslim people not included in the study, I wonder. Academics-like other strata of the society-may have unrecognised and hidden biases for or against a person/group/identifiers, however, hard they may try to undo it. Such bias, time and again, may get reflected in this way, buried inside the data and tables. Table 2 of the study has a caption of the obstetric history of pregnant women. Under this header, 15 women out of 113 were found to be overweight and obese. This medical condition increases the risk of gestational diabetes and high blood pressure.[5] Whether such an association was found in this study, I want to know. The authors conducted the study during COVID-19 times. Under a header of study procedure and study tools, they underscore the point where they observe COVID-19 appropriate behaviour. COVID-19 while pregnant increases the risk of gestational diabetes, pre-eclampsia and preterm birth.[6] Here is a case series of pregnancy and COVID-19 complications and their challenges.[7] There are several reports of pregnant women developing COVID-19 who then went on to develop severe COVID-19. Therefore, I want to know if some woman in this study also developed the infectious disease, and if yes, what was the outcome. Table 2 of the study results depicts preterm birth and term baby as two separate headers. Both the headers have a total number of 113 women but have different data for calculation. As the numbers are different, I want to know which data is accurate. Table 3 of the results has a header of medical history. Here, one variable is the present history of diabetes, and another one is the past history. But in the real world, diabetes, as a diagnosis once made, stays with the individual. The endocrinological disorder usually develops when more than half of the beta cell capacity to secrete insulin is lost,[8] and usually the loss-of-function is irreversible. Hence, what is the difference between the present and past history of diabetes here, I am left confused. In early stages, sometimes blood sugar is high and at other times not. Nevertheless, that apparent blood sugar control does not mean that the disease got cured and the diagnosis is erased. Diagnosis once made demands regular attention, as for this purpose, the diagnostic label carries weight even when the glycaemic profile is under check. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Abstract Background: Governments in many low-income settings, with high burdens of maternal mortality, provide schemes to encourage women for institutional childbirths. From the analysis of Indian data from the National Family Health Survey, 2015–2016, it was observed that the mean total out-of-pocket expenditure (OOPE) was found to be 2278 INR for childbirth, in government facilities in India. Aims: Our study aims in assessing the OOPE of postnatal women in a tertiary healthcare hospital. Patients and Methods: A cross-sectional study was conducted in the post-natal wards of a tertiary healthcare facility in New Delhi. All post-natal women present in the ward, without any complications, within 5 days of their delivery, were eligible for the study. In the said days, 312 women were approached, of them, 296 (94.87%) consented for the study. A self-developed pre-tested interview schedule was filled. Results: The median age of participants was 24 (23–27) years. More than 90% of them were from urban areas. All participants except two, incurred OOPE. The highest median expenditure was observed for the loss of wages of attendants (INR 2400), followed by expenses for medicine (INR 2000) and blood transfusion (INR 2000). Almost three-fourths of the participants paid for the OOPE by their own wage/salary or pension. One-fourth of the participants used their savings for meeting the expenditure. Conclusion: Despite several government assistance schemes, the OOPE continues to strain postpartum care.

Prostate biopsy is considered the gold standard in diagnosing prostate cancer (PCa). However, the field of PCa diagnostics has evolved significantly, with advancements in imaging, biomarker detection and artificial intelligence raising the question of whether a biopsy-free diagnosis is possible. The challenge lies in achieving high sensitivity and specificity without missing clinically significant PCa. Multiple different approaches have been investigated ranging from radiological, urine-based and seminal fluid-based to blood-based. In this review article, we will describe the currently available modalities and various prospects.

Abstract Background: Laparoscopic nephrectomy, a minimally invasive surgical technique for kidney removal, has transformed urological surgery since the 1990s. This approach offers numerous benefits over traditional open surgery, including reduced post-operative pain, shorter hospital stays and faster recovery. This study aims to evaluate the efficacy and outcomes of laparoscopic nephrectomy for benign non-functioning kidneys at Indira Gandhi Medical College (IGMC), Shimla. Materials and Methods: This observational study was conducted from July 2018 to June 2019, involving 20 patients with benign non-functioning kidneys due to stone disease, pelviureteric junction narrowing, renal tuberculosis and chronic pyelonephritis. Comprehensive pre-operative evaluations were performed, and patients underwent laparoscopic nephrectomy using the transperitoneal route. Data on surgical duration, blood loss, CO2 usage, complications and post-operative recovery were meticulously recorded and analysed. Results: The study included 20 patients, predominantly female (65%) and aged between 25 and 50 years (70%). Laparoscopic nephrectomy was successfully performed in 60% of cases, while 35% required conversion to open surgery. The mean operative time for successful laparoscopic nephrectomies was 103.7 min, with significantly lower blood loss (145 mL) compared to open surgery (350 mL, P = 0.003). Post-operative recovery was faster in the laparoscopic group, with 90% resuming oral intake within 1–2 days and 55% returning to normal activities within 30 days (P = 0.0072). The overall complication rate was 30%, including 10% major complications. Late presentations were attributed to a lack of awareness, financial constraints and reliance on quack treatments. Conclusion: Laparoscopic nephrectomy at IGMC Shimla demonstrated significant advantages over open surgery, including reduced operative time, blood loss, post-operative pain and faster recovery. The findings support the adoption of laparoscopic techniques as the preferred method for managing benign non-functioning kidneys in a tertiary care setting. However, the cost of disposable equipment and challenges in managing pyonephrotic and xanthogranulomatous kidneys necessitate careful patient selection and pre-operative planning.