Abstract: Objectives: The simultaneous occurrence of undernutrition and overnutrition in low- and middle-income countries, presents a significant challenge, particularly at the household level. The present study aimed to investigate the double burden of malnutrition (DBM) and its determinants focusing on the coexistence of undernutrition and overnutrition in the same household. Study Design: A community-based cross-sectional study was conducted among 612 rural Muslim children aged 1–5 years and their mothers. Methods: The data collection has been done using a stratified random sampling method and anthropometric and socio-economic, demographic data have been collected. A modified version of Kuppuswamy's socio-economic scale has been used to assess the socio-economic status of the households. The prevalence of stunting, wasting, and underweight among the under-5 children and prevalence of undernutrition, overweight, and obesity among their mothers has been assessed. The logistic regression analysis was applied for the assessment of risk factors for Logistic regression analysis was used to assess risk factors for undernutrition among children and for undernutrition and overweight/obesity among mothers. Results: The present study observed the presence of the DBM in mother-child pairs. Several socio-economic and demographic factors have been identified as contributing factors for the prevalence of DBM among mother-child pairs. Conclusion: The findings of the present study will be helpful in a deeper understanding of the prevalence and determinants of DBM among mother-child pairs in West Bengal, India, which will ultimately lead to enhancing public health.
Keywords: Body Mass Index (BMI), Double Burden of Malnutrition (DBM), Mother-child pairs, Undernutrition, Overweight, Obesity

Abstract: Introduction and Aim: India accounts for approximately one-fourth of the global tuberculosis (TB) burden, and undernutrition is estimated to contribute to more than half of all TB incidences. Prevalence of undernutrition weakens the immune system and increases susceptibility to TB infection and its progression, while TB exacerbates nutritional deficiencies due to its metabolic demands and reduced appetite in individuals. In a policy context, the Indian government incorporated large-scale intervention and operationalised the programmes nationwide to eradicate TB from India. This Systematic review synthesises biological, clinical, and policy-related evidence to examine the bidirectional relationship between TB and undernutrition in India and its implications for treatment outcomes and TB elimination efforts. Material and Methods: The keywords were used to search multiple electronic databases related to TB and undernutrition. Results: Inadequate healthcare infrastructure, health worker constraints, insufficient medication support, and logistical issues in drug and diagnostic supply chains remain common in the TB burden. The bidirectional relationship between TB and undernutrition highlights the gap in nutritional and financial support initiatives, especially in remote areas. Conclusion: Addressing these complex challenges through strengthened diagnostic capacity, healthcare system integration, nutrition-sensitive TB services, and patient-centred social protection is essential to accelerate progress towards TB elimination in India.
Keywords: Undernutrition, Tuberculosis, Double Burden of Tuberculosis, Biological Pathway of Tuberculosis, TB Elimination Policy

Abstract: Background: Cancer survival varies significantly across anatomical sites and demographic groups, particularly in low- and middle-income countries where regional data remains limited. Methods: A retrospective cohort study was conducted using hospital registry data from a tertiary care center in Bareilly, Uttar Pradesh, from 2014 to 2024. Kaplan–Meier survival analysis and Cox proportional hazards regression were used to evaluate survival patterns across major cancer sites. Results: A total of 32,581 patients were included. The most common cancers were oral cavity/pharynx (26%), female genital organs (23.6%), lung (16.4%), breast (15.1%), and gallbladder (10.2%). Overall mortality during follow-up was 6.2%. Survival was highest for colorectal and breast cancers and lowest for gallbladder and lung cancers (log-rank p < 0.001). Cox regression showed significantly higher mortality risk for gallbladder cancer (HR: 4.64), lung cancer (HR: 3.15), and oral cancer (HR: 2.54) compared to breast cancer. Conclusion: Survival varies significantly across cancer sites, with gallbladder and lung cancers showing the poorest outcomes. Region-specific screening and prevention strategies are needed, particularly for tobacco-related and gallbladder cancers in North India.
Keywords: Cancer survival, Epidemiology, Elderly population, Mortality patterns, Kaplan–Meier survival analysis.

Abstract: Background: India's state-level road-injury burden by road-user mode is poorly described. Methods: We analysed Global Burden of Disease 2021 subnational estimates for 32 Indian state and union-territory units, 2020-2023. Age-standardised DALY and death rates were extracted by mode. Pandemic rebound was assessed by regressing 2023 minus 2020 DALY-rate change on baseline rate; inequality was summarised with Gini coefficients. Results: In 2023, vulnerable road users contributed median 74.7% of state road-injury DALYs; motorcyclists contributed 42.2%. Cyclist DALY rates rose in 30/32 states. Motorcyclist injuries showed greatest inter-state inequality (Gini 0.238; top-bottom ratio 8.3). Conclusions: Indian road-safety policy should prioritise state-stratified vulnerable-road-user protection, especially motorcyclist safety and cyclist surveillance.
Keywords: Road-traffic injuries, vulnerable road users, disability-adjusted life years, ecological study, India.

Abstract: Background: Surgical site infections (SSIs) remain a major concern in orthopedic procedures, contributing to increased morbidity, prolonged hospitalization, and higher healthcare costs. This study aims to identify the risk factors, microbial profiles, and antibiotic resistance patterns associated with SSIs in orthopedic surgeries at Babol University of Medical Sciences over a ten-year period. Methods: This retrospective observational study reviewed medical records of patients who underwent orthopedic surgery and were diagnosed with SSIs between 2012 and 2022. Data regarding patient demographics, comorbidities, surgical characteristics, and laboratory findings were collected. Microbial evaluation included wound cultures and antibiotic susceptibility testing. Statistical analyses were performed to identify significant risk factors for SSIs. Results: Out of 572 patients, 71 developed SSIs. Significant risk factors included smoking, hypertension, diabetes mellitus, recent hospitalization, elevated BMI, urinary catheterization, general anesthesia, ASA scores below 3, the use of open drains, corticosteroid therapy, and prolonged operative time. Staphylococcus aureus was the most common pathogen, with a notable proportion of methicillin-resistant S. aureus (MRSA). Variation in antibiotic resistance patterns underscores the need for tailored prophylactic strategies. Conclusions: This study highlights the importance of monitoring risk factors and microbial resistance patterns to inform effective prevention and treatment strategies for SSIs in orthopedic surgery. Targeted interventions addressing the identified risk factors may help reduce the incidence and severity of these infections.
Keywords: Surgical site infections, orthopedic procedures, Staphylococcus aureus, microbial resistance.

Abstract: Background: Diagnosing metastatic squamous cell carcinoma (SCC) in cervical lymphadenopathy via FNAC can be challenging, especially in well-differentiated tumors lacking nuclear atypia or with cystic/necrotic changes. Benign lesions like inflamed keratinous cysts may mimic SCC. Hara et al.'s Five Parameter System (FPS), focusing on keratinized cell features, aids in differentiation. Aim: To determine the utility of five parameter system in diagnosing metastatic SCC showing secondary changes like cystic degeneration or abscess formation. Material and Methods: This four-year descriptive observational study included 70 cases of metastatic SCC (with cystic degeneration or abscess formation) and 45 controls with inflamed keratinous cysts. FNAC slides were evaluated using FPS, which assesses five cytoplasmic features: numerous orangeophilic cells, concentric arrangement of orangeophilic cells, bizarre-shaped orangeophilic cells, keratoglobules, and dyskeratosis. Results: Cervical lymphadenopathy accounted for 8.05% of all FNACs. Among 70 SCC cases, 56 were well-differentiated and 14 were poorly differentiated. The most common feature was presence of numerous orangeophilic cells (82.8%), followed by uneven filamentous cytoplasm (71.4%) and bizarre-shaped orangeophilic cells (65.7%). Concentric cell arrangements (8.57%) and keratoglobules (2.85%) were exclusive to SCC and absent in controls. Conclusion: FPS is an effective tool for FNAC diagnosis of metastatic SCC, particularly in cases with cystic degeneration or abscess formation. Features like orangeophilic cells and bizarre-shaped cytoplasm serve as reliable markers, aiding in distinction from benign mimickers and in grading SCC differentiation.
Keywords: Cervical lymphadenopathy, FNAC, metastatic squamous cell carcinoma, five-parameter system, cytomorphology.

Abstract: Background: Changes in lens-related biometric measurements may influence the likelihood of developing acute angle-closure disease. This study assessed lens thickness, vault, and position in subtypes of primary angle closure disease subtypes (PACS, PAC, and PACG) to determine their link with disease progression. It also compared these anterior segment parameters in PACD patients and a matched control group. Material and Methods: In this controlled study, 170 patients diagnosed with PACD (50 PACS, 60 PAC, 60 PACG) and 60 age- and gender-matched controls were recruited. Classification followed ISGEO guidelines. Comprehensive ocular examinations included visual acuity, refraction, slit-lamp biomicroscopy, gonioscopy, and intraocular pressure measurement. Swept-source optical coherence tomography (SS-OCT) and A-scan biometry were used to assess lens thickness (LT), lens vault (LV), axial length (AL), anterior chamber depth (ACD), and relative lens position (RLP). ANOVA and multivariate logistic regression, after adjusting for age and gender. Results: Lens vault, thickness, and axial factor progressively increased from PACS to PAC to PACG, with controls showing the lowest values (P < 0.001). PACG eyes had the shallowest ACD and shortest AL. Logistic regression identified increased LV (OR=3.32), higher RLP (OR=7.07), and shorter AL (OR=5.90) as independent risk factors for PACG. Visual acuity was poorest in PACG patients, and hypermetropia was more prevalent among PACD groups. Conclusion: Lens-related biometric measurements, especially LV, RLP, and AL, are crucial factors in the onset and progression of PACD. Individuals with thicker lenses positioned further forward and shorter AL face a greater risk and severity of angle closure. By identifying and tracking these characteristics early, timely treatment can help prevent permanent vision loss caused by PACG.
Keywords: Primary angle closure disease, primary angle closure glaucoma, Axial Length, Lens vault, Relative lens position

Abstract: Introduction: Suppurative thyroiditis represents infrequent pathology, which comprises less than 1% of thyroid diseases, since thyroid gland is well-protected by its capsule. Case Report: The 57-year-old female was urgently hospitalized with pain and tenderness of the left side of the neck. Ultrasonography revealed pronounced swelling of the neck soft tissues and non-homogenous mass 2 cm below the skin surface with the size of 13.0 x 10.0 x 12.0 cm, which was spreading behind the sternum. Contrast-enhanced CT of the neck demonstrated thyroid gland’s left lobe lesion with the size of 13.4 x 10.2 x 12.0 cm with a thin capsule, which merely contained fluid component with sings of calcification and accumulated contrast at the periphery, tracheal compression by 50% and massive locoregional lymphadenopathy. Abscess of the thyroid gland’s left lobe cyst was suspected. Considering the patient's stable condition, it had been decided to perform ultrasound-guided drainage of the formation under local anesthesia. Consequently, the patient underwent radical left hemithyroidectomy in a planned manner. Specimen histological picture met criteria of papillary thyroid cancer, infiltrative follicular variant, pT3aN0M0 with signs of lymphovascular invasion. Conclusions: Thyroid cancer as any neoplasia can be promoted by chronic inflammation or produce signaling factors inducing inflammatory process. As in this case, a male patient was treated for thyroid abscess, but eventually he was diagnosed with papillary thyroid cancer. Since a risk of having cancer increases with age, older patients should be monitored more closely for the presence of malignancy.
Keywords: thyroid abscess, thyroid cancer, papillary thyroid cancer, ultrasonography, drainage

Abstract: Phaeohyphomycosis is a term used to describe infections caused by fungi that contain melanin in their cell walls. The melanin apart from imparting a brown colour, contributes to its neurotropic nature and virulence. These fungi elicit an array of clinical syndromes, spanning solitary subcutaneous nodules associated with local trauma to life-threatening infections, such as brain abscess and disseminated disease. Bulk of the fungi aremolds, and frequently cause infection in immunocompetent individuals. Fungal brain abscesses are usually related to immunocompromised state. An exception to this rule is cerebral phaeohyphomycosis (CP). Despite that CP is an extremely uncommon cause of brain abscess, it is often fatal irrespective of the immune status. Hence, it has to be considered in the differential diagnosis of cerebral abscess and an early, aggressive therapeutic approach is essential to improve the patient’s outcome and reduce mortality.
Keywords: Phaeohyphomycosis, Fungi, Abscess, Melanin

Abstract: Post-infectious glomerulonephritis (PIGN) is a common cause of acute nephritic syndrome in children. However, the coexistence of PIGN with thrombotic microangiopathy (TMA) is rare and poses diagnostic and therapeutic challenges. We report a case of a 10-year-old boy presenting with nephritic–nephrotic syndrome, in whom kidney biopsy revealed features consistent with Post-infectious glomerulonephritis(PIGN) along with features of Thrombotic microangiopathy(TMA) involving a minority of glomeruli. The patient was clinically stable on follow-up with supportive therapy.
Keywords: Nephritic syndrome, Post infectious glomerulonephritis, Thrombotic Microangiopathy

Abstract: Background: Tuberculous orchitis is a rare manifestation of genitourinary tuberculosis as well as having nonspecific clinical features and is often confused with neoplastic or suppurative diseases. Xanthogranulomatous inflammation in the testis coexists very infrequently, and can add additional confusion to the diagnosis. Case Report: We document a rare case of a 56-year-old male who has a four-month history of scrotal swelling on the right side of the scrotum with several discharging sinuses. Radiology showed a huge, thick-walled heteroechoic collection that is indicative of a testicular abscess. Laboratory investigations, tumor markers, and pus culture were not remarkable. Histopathological analysis revealed granulomatous inflammation with epithelioid cells, Langhans giant cells, and foci of necrosis, as well as large sheets of foamy histiocytes which is characteristics of xanthogranulomatous inflammation. Ziehl-Neelsen staining was negative for acid-fast bacilli, but the diagnosis was confirmed by GeneXpert (CBNAAT) in which Mycobacterium tuberculosis was present with low bacillary load. Conclusion: Coexistence of tuberculous orchitis and xanthogranulomatous inflammation alongwith clinical manifestation of testicular abscess is rather an exception. It also focuses on how histopathology and molecular diagnostics should be integrated to make a proper diagnosis especially in smear negative paucibacillary extrapulmonary tuberculosis.
Keywords: Tuberculous Orchitis, Xanthogranulomatous Inflammation, Gene Expert, Testicular Abscess