Abstract: Background: Global diets are increasingly dominated by a narrow range of plant and animal species, despite the availability of thousands of edible options. This dietary homogenization has coincided with rising rates of noncommunicable diseases (NCDs). Nutritional biodiversity, measured through Dietary Species Richness (DSR)—the number of unique edible species consumed—offers a novel approach to assessing and improving diet quality, with potential implications for human and planetary health. Objective: To systematically review and synthesize evidence linking DSR and related species-level diversity metrics to public health outcomes, including nutrient adequacy, gut microbiome composition, inflammation, and all-cause mortality. Methods: We searched multiple databases (PubMed, Scopus, Embase, Web of Science) and grey literature sources up to May 2025. Studies were eligible if they reported on species-level dietary diversity (e.g., DSR, Hill numbers) and at least one health-related outcome. Risk of bias was assessed using ROBINS-I and RoB 2.0; certainty of evidence was evaluated using GRADE. Results: Fifteen studies met inclusion criteria (11 observational; 4 RCTs), encompassing &gt;450,000 participants across diverse settings. Micronutrient adequacy: Eight observational studies in LMICs and high-income countries found a consistent positive association between DSR and nutrient adequacy (+0.03 NAR per species; p < 0.001). Mortality: Meta-analysis of five European cohorts (n ? 450,000) showed a 37% reduced risk of all-cause mortality among those in the highest DSR quintile (pooled HR = 0.68; 95% CI: 0.60–0.77; I² = 46%). Microbiome and inflammation: RCTs using fermented food as a proxy for DSR showed increased ?-diversity (~10–15%) and reductions in inflammatory proteins (e.g., IL-6), though no trials directly manipulated DSR as an intervention. Conclusions: Species-level dietary diversity, particularly as measured by DSR, is a consistent and underutilized predictor of improved nutritional adequacy, microbiome resilience, and reduced mortality risk. Despite promising associations, RCTs explicitly manipulating DSR remain absent. Integrating DSR into dietary guidelines, clinical screening tools, and sustainability policies offers a novel and actionable pathway toward aligning nutrition and biodiversity goals.
Key words: dietary species richness, nutritional biodiversity, food systems, micronutrient adequacy, mortality, gut microbiome, ecological nutrition, biodiversity hypothesis

Abstract: Background: Dietary diversity is a key factor of child nutrition, yet its effect across different forms of undernutrition is not fully understood. Therefore, this study aims estimate the link between dietary diversity and undernutrition among children in Uttar Pradesh, and evaluate the moderating effect of socio-economic status on this relationship. Materials and Methods: Data from the NFHS-5 (2019–21) were analyzed for 29,196 children aged 6–59 months. Nutritional status was classified using WHO child growth standards. Graphical representation and chi-square tests are used to assess the association between malnutrition with background characteristics. Multinomial logistic regression is used to identify predictors of nutritional outcomes. R studio software was used to analyze the data. Results: Stunting (43.6%) was most prevalent in children aged 36–59 months, while wasting and underweight were found in the 6–23-month age group (p < 0.001). Boys had a higher prevalence of malnutrition than girls. Child from poorer households had significantly higher risks of stunting (RRR = 1.59), underweight (RRR = 1.57), and multiple undernutrition (RRR = 1.90). Maternal education showed a protective effect across all forms of undernutrition. The effect of low dietary diversity was not significant in adjusted models, but an interaction term revealed that its negative impact was pronounced among children from poor households especially for multiple undernutrition (RRR = 2.89; p < 0.001). Conclusion: Undernutrition is primarily affected by poverty/low maternal education, rather than dietary diversity alone. Low dietary diversity impact on nutritional status is prominent in poorer households. Targeted, multi-sectoral interventions that promote maternal education, dietary improvements, and healthcare access are essential to reduce nutritional disparities among children in Uttar Pradesh.
Key words: undernutrition, dietary diversity, child malnutrition, Uttar Pradesh, NFHS-5.

Abstract: Globally, one in three adults suffer from multimorbidity. The challenges of multimorbidity in low-middle income countries are accentuated by social inequity, environmental degradation and inefficiencies in health systems. This study examines the prevalence and determinants of multi-morbidity across population sub-groups using the database of 71^st round of National Sample Survey. ‘Multi-morbidity’ is operationalised in terms of ‘number of hospitalizations.’ Individuals reporting multiple hospitalizations due to multiple ailments are considered as a case of multi-morbidity. We find that 8.43% adults reported multimorbidity. Pearson’s chi squared test is performed to see whether any relationship exists between its episode and socio demographic characteristics. Elderly and women are the commonly affected groups. Binary logistic regression analyses shows a significant association between multi-morbidity and variables like - age, gender, geographic zones and the insurance coverage. The study manifests novel approach of defining ‘multi-morbidity’ and highlights the need to design age and gender specific combating strategies.
Key words: Chronic morbidity, multi-morbidity, National Sample Survey 71^st round, in-patient visits, hospitalization.

Abstract: Background: The shortage of healthcare professionals and unequal distribution of health workers in many developing nations are widely recognized. Still, there has been limited effort to assess the level of inequality amongst healthcare professionals in the Kingdom of Saudi Arabia (KSA). This research investigates the distribution of physicians, dentists, nurses and midwives, and pharmacists among the 20 healthcare regions in the KSA. Materials and Methods: An analysis of secondary data was carried out using the Statistical Yearbook of the Saudi Ministry of Health for the year 2022. The research focused on determining the ratio of physicians, dentists, nurses, and pharmacists per 1,0000 people employed in the healthcare facilities of the Ministry of Health and the private sector in the 20 health regions of the KSA. The examination included evaluating the distribution of the healthcare professionals in different regions using the Lorenz curve, and the Gini coefficient. Results: There are fair distribution of physicians, dentists, nurses, and pharmacists across different regions. The mean Gini coefficient calculated for physician distribution was 0.11, dentists 0.08, nurses and midwives 0.16, and pharmacists 0.12 respectively, suggesting fair healthcare professionals distribution across regions. The research also highlighted the additional requirements for 4493 dentists, 69551 nurses and midwives, and 2811 pharmacists to adhere to the global benchmark of 8.2 dentists, 70.6 nurses and midwives, and 9.4 pharmacists per 10000 population. Conclusion: The research emphasizes the significance of focused healthcare planning and policy interventions to distribute healthcare professionals equally across the Kingdom's health regions.
Key words: healthcare professionals, inequality, health regions, Saudi Arabia

Abstract: Aim: Anaplastic thyroid carcinoma (ATC) is highly aggressive, comprises <4% with dismal prognosis. This study examines the clinical, pathological, prognostic features and outcomes. Methods: We retrospectively analysed 15 cases of ATC over 6-years. Clinicopathological data, immunohistochemistry, morphological subtypes, treatment and survival were assessed using Kaplan-Meier curves. Results: The mean age was 66.1 years, with female predominance(M:F=1:2). Commonest symptom included neck swelling. 33.3% had long-standing goitre with rapid enlargement and 80% presented with tumours >5cm exhibiting local invasion(80%), distant metastasis(60%), particularly to the lungs(53.3%) and bones(26.6%). Histological subtypes included epithelioid(33.3%), sarcomatoid(33.3%), squamous(26.6%) and pleomorphic/rhabdoid(6.6%) with coexisting differentiated thyroid carcinoma(DTC) noted in 46.6%. Epithelioid and squamous ATC showed higher association with DTC and exhibited high tumour infiltrating lymphocytes. Immunohistochemistry revealed PAX8(66.6%), p53(73.3%) and BRAF(53.3%) positivity; latter showing expression in epithelioid(26.6%) and squamous(13.3%) ATC. Two patients with BRAF associated squamous ATC arising from papillary thyroid carcinoma precursor showed prolonged survival. The median overall survival was one month. Conclusions: ATC is an aggressive thyroid malignancy with poor outcomes. Histological subtype and BRAFV600E status may aid in prognostication and targeted therapy selection.
Key words: Anaplastic carcinoma, BRAF V600E, Differentiated thyroid carcinoma, India

Abstract: Objective: To evaluate the oral cavity of tobacco and non-tobacco consumers, focusing on the severity of oral submucous fibrosis (OSF) using clinical diagnostic scales and molecular biomarkers. Design: A comparative cross-sectional study. Methods: A total of 200 individuals scheduled for general surgeries (100 tobacco consumers and 100 non-tobacco consumers) were assessed. OSF severity was evaluated using Mallampati Classification (MPC), Maximal Mouth Opening (MMO), dysphagia scoring, and Thyromental Distance (TD). Additionally, the Kallikrein, Adam, and Cathepsin genes were examined as molecular biomarkers due to their relevance in various health conditions. Results: A significantly higher number of males were observed in the tobacco group (p-value = 0.0018). The mean age was 48.02 ± 16.5 years for tobacco users and 46.52 ± 13.3 years for non-users, with no significant age difference (p-value = 0.4805). Significant differences were found between the two groups in MPC, MMO, and dysphagia (all p-values = 0.000), indicating higher OSF severity in tobacco consumers. No significant difference was observed in TD (p-value = 0.761). Molecular analysis revealed that 10% of participants tested positive for Kallikrein gene amplification, while Adam and Cathepsin gene amplification was not detected. Conclusion: Tobacco consumption is associated with significant changes in oral diagnostic parameters, suggesting an elevated risk of OSF. The clinical diagnostic scales used are effective in identifying OSF severity, and Kallikrein gene amplification may serve as a potential molecular marker. These findings support the integration of clinical and molecular diagnostics for early detection in tobacco chewers.
Key words: Modified Mallampati Classification (MMC), Tobacco, Kallikrein, Cathepsin, Adam

Abstract: Black Plastics (BC) are widely used in food packaging, toys, consumer electronics, automobile parts and have raised growing concerns about their potential impacts on human health. These plastics which are often made from recovered electronic trash (e-waste), can include a complex mixture of toxic compounds such as brominated flame retardants, heavy metals, and persistent organic pollutants. This paper critically evaluates the existing scientific understanding of black plastics as potential endocrine-disruptive materials for vulnerable populations. Relevant literature was sourced from online sources and published articles between January and June 2025. This study investigated the BC chemical compounds capable of mimicking or interfering with hormonal activity and its mechanism, as well as the impacts on public health, the environmental and transgenerational repercussions. The analysis emphasizes the urgent need for more comprehensive toxicological research to reduce human exposure to endocrine-disrupting compounds found in black plastics.
Key words: Black plastics, Endocrine Disruption Chemicals, Hormonal system, Mitigation

Abstract: Perivascular tumors are rare mesenchymal neoplasms of unclear line of differentiation, presumed to be derived from pericytes or a modified perivascular cell, with very few articles published in the literature. It is classified as benign, intermediate, and malignant. We hereby report five cases of perivascular tumor. Three cases were reported as myopericytoma (MPC), one case was reported as a myofibroma(MF), while one case was of glomangioma. Myopericytomas are typically benign, slow-growing, but rare malignant variants exist- hence, complete excision and follow-up are advised. Myofibromas, on the other hand, are commonly solitary and benign, but infantile myofibromatosis can be aggressive or fatal if visceral involvement occurs. Glomangiomas are benign, though multiple lesions (glomangiomatosis) can be painful and cosmetically concerning. Hence, differentiating perivascular tumors is critically important in clinical practice and pathology because while they share overlapping histological features as perivascular tumors, they differ in biological behaviour, treatment approach, syndromic associations, and immunohistochemical profile.
Key words: Perivascular tumors, Myopericytoma, Myofibroma, Glomangioma

Abstract: Background: Brown tumors (BT) with an overall incidence of 2-3%, are rare but characteristic presenting features of primary hyperparathyroidism (PHPTH) which are often missed, resulting in delayed diagnosis. We present two unique cases where bony lesions were the initial presentation of BT, ultimately unravelling PHPTH. Method: First case involves a 43 year male presenting with repeated femur fractures, generalized fatigue and bony pain with Bone scan suggesting Metabolic bone disease. Second case was of a 36 year male presenting with painful deformity at left humerus fracture site. Result: Both cases on histopathology were reported as Brown tumor, with subsequent work up revealing metabolic derangements and Parathyroid adenoma in each. Conclusion: This report highlights that fractures can mask rare osteolytic lesions like BT, which may serve as the first clue to PHPTH. Histopathological evaluation of debrided tissue becomes crucial to catch the lesion early as it is gold standard for diagnosis complemented with a multidisciplinary approach.
Key words: Brown tumor, Primary hyperparathyroidism, Giant cell rich lesions, Pathological fractures, Parathyroid Adenoma

Abstract: The parotid gland mucoepidermoid carcinoma (MEC), ss the most common primary malignant tumor of the salivary glands. Metastatic tumors of parotid account for approximately 25% of all cases. The commonest malignancies to spread to intraparotid lymph nodes are squamous cell carcinoma, followed by melanoma and, less frequently, cancers from the oral cavity. Usually, cutaneous melanoma in the head and neck area is the precursor of malignant melanoma in the parotid gland. However, the exact process underlying the existence of melanin pigment in salivary gland tissue is unknown. A 72-year-old woman with a history of conjunctival melanoma arrived at the otolaryngology outpatient clinic complaining of preauricular pain and swelling. It was a 1.5 × 1.5 cm lesion. Given the background, cytology revealed high-grade malignancy with pigmentation upon fine needle aspiration, which was suggestive of malignant melanoma. On Cellblock and immunohistochemistry, it was confirmed as pigmented MEC. This case underscores the importance of immunohistochemistry and CB preparation in both diagnosis and patient care. In pathology, the existence of melanin pigment is a fascinating phenomenon, and melanin pigment that causes lesions is not invariably a sign of malignant melanoma.
Key words: Pigmented, mucoepidermoid carcinoma, parotid gland, major salivary gland, cell block, melanocytes, melanoma

Abstract: Background: The thyroglossal duct cyst (TGDC) is the commonest embryological thyroid developmental abnormality. It is usual to find dispersed ectopic thyroid tissue within TGDCs, but malignant transformation is expected to occur in less than 1% of cases. We present this unusual case which was misdiagnosed on fine needle aspiration cytology (FNAC) as colloid goitre. Case Report: A 60 year old female presented with swelling in front of neck. At ultrasound examination a diagnosis of benign lesion was rendered as TIRADS 0 in left lobe, TIRADS I in right lobe and TIRADS III in the isthmus. Thyroid hormone assay were within normal limits. At FNAC a diagnosis of Colloid Goitre (TBSRTC) was made. Computed tomography of neck was also suggestive of a benign solid cystic lesion. Left hemi thyroidectomy was done and specimen sent for histopathology which was reported as papillary carcinoma-classic type arising in a thyroglossal duct cyst. Conclusion: The present case highlights the importance of considering malignancy, however infrequent, in the differential diagnosis of TGDC masses, even in the absence of overt suspicious features. The case underscores the need for thorough pathological examination of excised TGDCs to identify such unexpected findings
Key words: Thyroglossal duct cyst, papillary thyroid carcinoma, Thyroid, TIRAD

Abstract: Achalasia is an uncommon esophageal motility disorder characterized by the failure of the lower esophageal sphincter to relax in response to swallowing and weak to absent esophageal peristalsis. In advanced stages, the esophagus gets grossly dilated, attaining a sigmoid configuration. We present one such case of sigmoid esophagus due to its rare occurrence. The managed was managed successfully with laparoscopic Heller myotomy.
Key words: Esophageal achalasia, barium swallow, esophagoscopy; manometry, sigmoid esophagus, Heller’s myotomy, myenteric plexus, esophageal sphincter

Abstract: Introduction: Xanthogranulomatous inflammation (XGI) is an uncommon variant of chronic inflammation and a well-established pathological entity involving various organs and systems. The commonest site of XGI is the gall bladder and kidney. It is rare in the head and neck region. Only 13 cases have been reported in the head and neck region to date at different locations. The exact pathophysiology of XGI remains unexplained. It may be associated with trauma, post-surgery, infection, obstruction, defective lipid transport, and immunological disturbances, and is often confused with a malignant neoplasm. The conclusive diagnosis is made through histopathology. Case Report: We present a unique case of a huge neck mass measuring 25x25 cm in a 76-year-old patient who was diagnosed clinically and radiologically as a thyroglossal cyst and/or colloid goitre, respectively. On histopathological examination, the mass showed extensive XGI replacing the bilateral lobes of the thyroid parenchyma. The differentials included malakoplakia, tuberculosis, or metastatic cystic squamous cell carcinoma. Conclusion: To the best of my knowledge, this is the first reported case where the primary xanthogranuloma of the thyroid presented as a huge cystic neck mass in the absence of any congenital cysts, and the patient was both surgically naïve and non-diabetic. The histopathological examination is mandatory to rule out the possibility of other lesions. However, the pathophysiology is unexplained. Awareness of this inflammatory lesion is important to the pathologist and treating surgeon to prevent extensive surgery.
Key words: Xanthogranuloma, thyroid, neck mass, xanthogranulomatous inflammation, chronic inflammation

Abstract: Patients with polyorchidism (multiple testes) may exhibit scrotal swelling, experience torsion, or have no symptoms, whereas Rathke cleft cysts are commonly identified incidentally through imaging studies or may be associated with pituitary hormonal deficiency symptoms. There is no reported shared etiological basis or mechanism between the two conditions. A 58-year-old man presented with confusion, low blood sugar, low blood pressure, and slow heart rate. He was diagnosed with Addisonian crisis caused by panhypopituitarism and multiple hormone deficiencies. Imaging identified a Rathke cleft cyst and bilateral supernumerary testes. Hormone replacement therapy resulted in clinical improvement, with the patient maintaining stability and remaining asymptomatic after six months of treatment. While these anomalies originate from distinct embryological processes, their simultaneous occurrence may indicate a possible underlying developmental or genetic associations. To date, no direct relationship has been identified; additional research is warranted to further examine any shared mechanisms or genetic determinants. This report presents a rare clinical case involving the simultaneous occurrence of multiple testes (polyorchidism) and hormonal deficiencies linked to a Rathke’s cleft cyst (RCC), raising questions about a possible developmental or genetic association between these distinct anomalies.
Key words: Rathke cleft cyst, Polyorchidism, testicular descent, panhypopituitarism