Journal of Advanced Scientific Research

Teacher–Student Relationship and Perceived Learning Outcomes among Phase I MBBS Students: A Cross-Sectional Study

2026-06-04T13:04:20+00:00

Background: Interaction between teachers and students affects both the intellectual and the emotional development of the
medical students, especially at initial preclinical years. During this academic transition from school to medical university, the
teachers not only teach but serve as mentors, emotional guides, and moral role models. While existing studies have addressed
some aspects of teacher behavior and learning cultures, fewer studies have ventured into the perceptions of Phase I MBBS
students especially in South Asian settings.
Objective: The current research was undertaken to assess the perceptions of Phase I MBBS students regarding teacher–student
relationships and their association with perceived learning outcomes.
Methodology: A cross-sectional online questionnaire survey was conducted among 150 Phase I MBBS students at Government
Medical College, Srinagar, J&K, India, in 2025.
The pre-tested questionnaire consisted of Likert-scale, multiple-choice, and open-ended questions which assessed the students’
perception of safety, favoritism, emotional support, and ideal teacher characteristics. Quantitative results were presented using
descriptive statistics and chi-square tests, and qualitative responses were coded thematically.
Results: Of 150 students (65% private school, 60% female), 88% indicated being encouraged by teachers and 82% perceived
their teachers as friendly. However, 42% perceived favouritism and only 60% claimed students were treated equally by teachers.
Positive attributes (friendliness, clarity, sensitivity) and concerns (favouritism to high-achievers, no feedback) were revealed
in open-ended comments. Students proposed solutions such as implementing anonymous feedback mechanisms and promoting
more balanced participation among all learners.
Conclusion: While most Phase I MBBS students perceive their teachers as supportive and encouraging, concerns of favoritism
and bias are still relevant. The study emphasizes that student involvement makes the teachers friendly, fair, and emotionally
supportive. Institutional strategies like facilitating teacher development, ongoing feedback, and integration strategies can promote
the quality of the educational environment.

A Comparative Prospective Study Evaluating Functional and Radiological Outcomes of Suprapatellar Versus Infrapatellar Approaches for Intramedullary Nailing in Patients with Distal Tibial Shaft Fractures

2026-06-04T12:55:17+00:00

Background: Distal tibial shaft fractures are common injuries associated with high-energy trauma and functional disability. Intramedullarynailing is the standard treatment; however, the optimal surgical approach, suprapatellar or infrapatellar, remains debated, particularly in resourcelimitedsettings like Bihar, where early mobilization and functional recovery are essential. Aim: To compare the functional and radiological outcomes of suprapatellar versus infrapatellar approaches for intramedullary nailing in patientswith distal tibial shaft fractures. Methodology: This prospective comparative study was conducted at a tertiary care center in Patna over one year, including 40 patients withdistal tibial shaft fractures. Patients were equally divided into suprapatellar (n=20) and infrapatellar (n=20) groups. Outcomes assessed includedfracture union time, malalignment, anterior knee pain (VAS), functional outcome using Lysholm knee score, and postoperative complications. Statistical analysis was performed using SPSS version 20.0, with p < 0.05 considered significant. Results: The suprapatellar group demonstrated significantly shorter mean time to union (17.2 vs 19.6 weeks, p = 0.02), lower malalignmentrates (10 vs 30%, p = 0.04), and better functional outcomes with higher Lysholm scores (91.6 vs 85.3, p = 0.01). Anterior knee pain wassignificantly lower in the suprapatellar group (VAS 1.8 vs 3.6, p = 0.003). Complication rates were lower in the suprapatellar group, with nosignificant increase in infection or implant failure. Conclusion: Suprapatellar intramedullary nailing offers superior radiological alignment, faster fracture union, improved functional recovery,and reduced anterior knee pain compared to the infrapatellar approach, making it a preferable technique for distal tibial shaft fractures in theBihar population.

A Prospective Observational Study Evaluating Thyroid Hormone Profile Alterations in Patients with Acute Coronary Syndrome and Their Association with Clinical Outcomes

2026-06-04T12:59:05+00:00

Background: Thyroid hormones play a crucial role in cardiovascular physiology, influencing myocardial contractility, vascular resistance, andmetabolic regulation. Alterations in thyroid hormone levels, particularly low triiodothyronine (T3), are frequently observed in patients withAcute Coronary Syndrome (ACS) and may impact disease severity and prognosis. Aim: To evaluate thyroid hormone profile alterations in patients with ACS and determine their association with clinical outcomes in a tertiarycare center in Bihar. Methodology: This prospective observational study included 100 adult patients diagnosed with ACS during the study period. Patients wererandomly selected from those presenting to the outpatient and emergency departments. Thyroid function tests (Free T3, Free T4, and TSH) weremeasured within 24 hours of admission using chemiluminescent immunoassay. Patients were categorized into euthyroid and thyroid dysfunctiongroups. Clinical outcomes, including mortality, heart failure, arrhythmias, cardiogenic shock, and duration of hospital stay, were recorded andanalyzed using appropriate statistical tests. Results: Thyroid dysfunction was observed in 40% of patients, with low T3 syndrome being the most common abnormality (22%). Patientswith thyroid dysfunction had significantly higher mortality (25 vs 5%), increased incidence of heart failure (40% vs 13.3%), arrhythmias (35 vs10%), and longer hospital stay (8.6 ± 2.1 vs 5.2 ± 1.3 days) compared to euthyroid patients (p <0.05). Conclusion: Thyroid hormone abnormalities are common in ACS and are significantly associated with adverse clinical outcomes. Thyroidfunction testing may serve as a simple and cost-effective prognostic tool for risk stratification in ACS patients.

Prospective Evaluation of Serum Uric Acid as a Risk Factor for Acute Ischemic Stroke in Adult Patients Compared to Normouricemic Individuals

2026-06-04T13:00:12+00:00

Background: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide. While traditional risk factors like hypertension,diabetes, and dyslipidemia are well-established, the role of serum uric acid (SUA) as a potential independent risk factor remains under investigation. Hyperuricemia may contribute to endothelial dysfunction, oxidative stress, and vascular inflammation, thereby increasing stroke risk. Aim: To evaluate the association between serum uric acid levels and acute ischemic stroke and assess its correlation with stroke severity in adultpatients attending a tertiary care center in Bihar, India. Methodology: This prospective observational study enrolled 110 AIS patients and 110 age- and sex-matched normouricemic controls duringthe study period. Clinical evaluation, laboratory investigations including serum uric acid, and neuroimaging (CT) were performed. Stroke severitywas assessed using the NIH Stroke Scale (NIHSS). Statistical analysis included t-tests, chi-square tests, correlation analysis, and multivariatelogistic regression to determine independent risk factors for AIS. Results: Mean SUA levels were significantly higher in AIS patients compared to controls (6.9 ± 1.4 mg/dL vs 5.3 ± 1.2 mg/dL, p < 0.001). Hyperuricemia was observed in 52.7% of AIS patients versus 20% of controls. Elevated SUA correlated positively with NIHSS scores, indicatinggreater stroke severity. Logistic regression identified hyperuricemia as an independent risk factor for AIS (OR 3.8, 95% CI 2.1–6.8, p < 0.001),along with hypertension and smoking. Conclusion: Elevated serum uric acid is significantly associated with the occurrence and severity of acute ischemic stroke, serving as a modifiable,independent risk factor. Routine SUA assessment may aid early risk stratification and preventive strategies in high-risk populations.

A Prospective Comparative Study Evaluating Lipid Profile Alterations in Adults with Newly Diagnosed Hypertension versus Normotensive Individuals

2026-06-04T13:02:07+00:00

Background: Hypertension is a major global health problem and an important risk factor for cardiovascular disease. Dyslipidemia frequentlycoexists with hypertension and accelerates atherosclerosis, thereby increasing the risk of adverse cardiovascular outcomes. Early identificationof lipid abnormalities in newly diagnosed hypertensive patients is crucial for effective risk stratification and preventive management, particularlyin resource-limited settings like Bihar, where patients often present late to tertiary care centers. Aim: To evaluate and compare lipid profile parameters in adults with newly diagnosed hypertension and normotensive individuals attending atertiary care referral center in Bihar. Methodology: This prospective comparative study included 200 participants (100 newly diagnosed hypertensive patients and 100 normotensivecontrols) selected randomly from the medicine OPD over a 6-month period. Blood pressure was measured using standard guidelines. Fastinglipid profile, including total cholesterol, triglycerides, LDL, HDL, and VLDL, was estimated using enzymatic methods. Data were analyzed usingSPSS version 20. Independent t-test, chi-square test, and Pearson correlation were applied, with p <0.05 considered statistically significant. Results: Hypertensive patients had significantly higher mean levels of total cholesterol, triglycerides, LDL, and VLDL and significantly lowerHDL levels compared to normotensive individuals (p <0.001). Dyslipidemia was present in 72% of hypertensive subjects versus 36% of controls. A significant positive correlation was observed between blood pressure levels and total cholesterol, triglycerides, and LDL, while HDL showeda negative correlation. Conclusion: Newly diagnosed hypertensive patients demonstrate significant lipid abnormalities at presentation. Routine lipid screening atdiagnosis is essential for early cardiovascular risk assessment and integrated management to reduce long-term morbidity and mortality.

Prospective Evaluation of Hepatic Dysfunction in Patients with Dengue Fever: A Clinical and Biochemical Outcome Study

2026-06-04T13:03:16+00:00

Background: Dengue fever is a rapidly emerging mosquito-borne viral illness with a wide clinical spectrum ranging from mild febrile disease to severe life-threatening complications. Hepatic dysfunction is increasingly recognized as a significant systemic manifestation of dengue infection and may serve as an early predictor of disease severity and adverse clinical outcomes. However, prospective data from eastern India, particularly Bihar, remain limited.
Aim: To prospectively evaluate the clinical profile and biochemical pattern of hepatic dysfunction in patients with dengue fever and determine its association with disease severity and clinical outcomes in a tertiary care center in Bihar.
Methodology: This prospective observational study included 120 adult patients with laboratory-confirmed dengue infection selected randomly from those presenting to the outpatient department over a six-month period. Detailed clinical evaluation and laboratory investigations, including liver function tests (AST, ALT, bilirubin, albumin, and coagulation profile) were performed. Hepatic dysfunction was assessed and correlated with the WHO dengue severity classification and clinical outcomes. Statistical analysis was performed using SPSS version 20.0, with p < 0.05 considered significant.
Results: Elevated AST and ALT were observed in 85% and 78.3% of patients, respectively, with AST levels exceeding ALT. Hyperbilirubinemia and hypoalbuminemia were noted in 22.5 and 28.3% of cases. Significant association was found between hepatic dysfunction and severity of dengue (p < 0.05). Patients with severe dengue had markedly elevated transaminases, longer hospital stay, and higher ICU admission rates. Mortality was observed in 1.7% of cases, all associated with severe hepatic involvement.
Conclusion: Hepatic dysfunction is highly prevalent in dengue fever and strongly correlates with disease severity and outcomes. Routine liver function assessment is a valuable, cost-effective prognostic tool for early identification of high-risk patients in tertiary care settings.

A Prospective Comparative Study Evaluating Functional and Radiological Outcomes of Intertrochanteric Femur Fractures Treated with Proximal Femoral Nail (PFN) Versus Proximal Femoral Nail Antirotation II (PFNA2) in Adult Patients

2026-06-04T13:08:12+00:00

Background: Intertrochanteric femur fractures are common in elderly populations and are associated with high morbidity and mortality. Intramedullary fixation using proximal femoral nail (PFN) and proximal femoral nail antirotation II (PFNA2) has become the preferred treatmentmodality due to biomechanical advantages and early mobilization. However, the optimal implant remains debated, especially in osteoporoticpatients in resource-limited regions such as Bihar. Aim: To prospectively compare the functional and radiological outcomes of intertrochanteric femur fractures treated with PFN versus PFNA2in adult patients. Methodology: This prospective comparative study was conducted over one year at a tertiary care center in Bihar and included 40 adult patientswith intertrochanteric fractures. Patients were randomly allocated into two groups: PFN (n=20) and PFNA2 (n=20). Intraoperative parameters,fracture union, complications, and functional outcomes using the Harris Hip Score (HHS) were evaluated at 6 weeks, 3 months, 6 months, and12 months. Statistical analysis was performed using SPSS, with p <0.05 considered significant. Results: The PFNA2 group showed significantly shorter operative time and less blood loss compared to PFN (p <0.05). Mean fracture uniontime was earlier in PFNA2 (13.6 weeks) than in PFN (14.8 weeks). At 12 months, mean HHS was higher in PFNA2 (88.9) compared to PFN(84.6) (p <0.05). Implant-related complications were fewer in the PFNA2 group. Conclusion: PFNA2 demonstrates superior operative efficiency, earlier union, and better functional outcomes compared to PFN, making it apreferable implant for intertrochanteric femur fractures, particularly in osteoporotic elderly patients in resource-limited settings.

Surgical Outcomes in Adult Patients Undergoing Pterygium Excision with Conjunctival Autograft: A Prospective Clinical Study

2026-06-08T07:01:09+00:00

Background: Pterygium is a common ocular surface disorder in tropical regions characterized by fibrovascular growth of conjunctival tissue
over the cornea. Surgical excision remains the definitive treatment, and conjunctival autografting is the preferred technique due to its low
recurrence rates and superior cosmetic and functional outcomes.
Aim: To evaluate the surgical outcomes of pterygium excision with conjunctival autograft in adult patients attending Anmmch Gayaji Bihar.
Methodology: This prospective observational study included 60 adult patients randomly selected from the ophthalmology outpatient with
primary pterygium who underwent pterygium excision with conjunctival autograft over a six-month period. Preoperative and postoperative
evaluations included best corrected visual acuity, corneal astigmatism, graft status, complications, and recurrence. A follow-up was conducted
for six months.
Results: The mean best corrected visual acuity improved significantly from 0.42 ± 0.18 logMAR preoperatively to 0.18 ± 0.12 logMAR
postoperatively (p < 0.001). Mean corneal astigmatism reduced from 2.15 ± 0.72 diopters to 0.85 ± 0.44 diopters (p < 0.001). Postoperative
complications were minimal, with graft edema observed in 10% and graft displacement in 5% of cases. Recurrence was noted in only 5% of
patients at six months.
Conclusion: Pterygium excision with conjunctival autograft is a safe, effective, and reliable surgical method that provides excellent functional
and anatomical outcomes with low recurrence, making it suitable for routine clinical practice in high-risk populations.

Etiological Profile and Clinical Outcomes of Corneal Ulcers in a Tertiary Care Hospital Population: A Prospective Observational Study

2026-06-08T07:03:48+00:00

Background: Corneal ulcers are a significant cause of ocular morbidity and preventable blindness, particularly in developing regions. The
etiological spectrum and clinical outcomes vary with geography, climate, occupational exposure, and access to eye care. Region-specific prospective
data are essential to guide early diagnosis, management, and prevention strategies.
Aim: To evaluate the etiological profile, predisposing factors, and clinical outcomes of corneal ulcers among patients presenting to a tertiary
care referral hospital in Bihar with ANMMCH gayaji Bihar.
Methodology: This prospective observational study was conducted over six months included randomly selected patients presenting to
the outpatient department with clinically diagnosed corneal ulcers were enrolled. Detailed demographic and clinical data were recorded.
Comprehensive ocular examination and microbiological evaluation, including corneal scraping for smear and culture, were performed. Patients
were treated as per standard protocols and followed up to assess healing, complications, and visual outcomes.
Results: A total of 120 patients were included, with a predominance of rural, working-age males. Ocular trauma, particularly with vegetative
matter, was the most common risk factor. Fungal keratitis emerged as the most frequent etiology, followed by bacterial keratitis. Visual
improvement was observed in over half of the patients, while poorer outcomes and complications were more common in fungal ulcers and
cases with delayed presentation.
Conclusion: Corneal ulcers in Bihar are largely trauma-related and fungal in origin, with delayed presentation contributing to adverse outcomes.
Early referral, prompt microbiological diagnosis, and targeted therapy are vital to reduce vision-threatening complications.

A Prospective Study Examining the Clinical and Functional Outcomes of Adults with Proximal Humerus Fractures Treated using a Locking Compression Plate (LCP)

2026-06-08T07:09:24+00:00

Background: Proximal humerus fractures constitute a common orthopedic injury requiring surgical intervention to restore anatomy and
function. Locking compression plates (LCP) have gained popularity due to their stability and suitability.
Aim: To evaluate the clinical and functional outcomes of adult patients with proximal humerus fractures treated using locking compression
plates at a tertiary care referral center in Bihar.
Methodology: This prospective observational study included 36 randomly selected adult patients with displaced proximal humerus fractures
managed with open reduction and internal fixation using LCP. Patients were followed for a minimum of 12 months. Clinical assessment included
pain evaluation using the visual analog scale, shoulder range of motion, and functional outcome using the Constant–Murley score. Radiological
union and postoperative complications were also recorded.
Results: The mean age of patients was 46.8 years, with male predominance. Road traffic accidents were the most common mode of injury.
Radiological union was achieved in all patients, with a mean union time of 12.3 weeks. The mean Constant–Murley score at final follow-up was
76.4. Excellent to good functional outcomes were observed in 72.2% of patients. Complications occurred in 16.7% of cases. Better outcomes
were observed in two- and three-part fractures compared to four-part fractures.
Conclusion: Locking compression plate fixation is an effective and reliable modality for managing displaced proximal humerus fractures in
adults, providing good functional outcomes with acceptable complication rates when combined with proper surgical technique and rehabilitation.

Effect of Damage Control Orthopedics versus Early Total Care on Mortality and Functional Outcomes in Polytrauma Patients: A Prospective Observational Study

2026-06-08T07:16:21+00:00

Background: Polytrauma is a leading cause of morbidity and mortality in developing countries. Orthopaedic injuries are common in these
patients and significantly influence survival and long-term functional outcomes. Two principal management strategies damage control orthopaedics
(DCO) and early total care (ETC) are used based on patient physiology and injury severity.
Aim: To compare the effect of damage control orthopaedics versus early total care on mortality and functional outcomes in polytrauma patients
presenting to a tertiary care referral centre in Bihar.
Methodology: This prospective observational study included 102 polytrauma patients over a 6-month period. Patients were managed using
either DCO (n=52) or ETC (n=50) based on clinical status. Outcomes assessed included mortality, complications (ARDS, sepsis, MODS),
ICU and hospital stay, fracture union, and functional outcome using the Lower Extremity Functional Scale at 3 months. Statistical analysis was
performed using SPSS version 20.0 with p < 0.05 considered significant.
Results: Patients in the DCO group had significantly higher injury severity scores. Mortality was higher in the DCO group (23.1%) compared
to ETC (12%). The DCO group had significantly longer ICU stay, ventilator days, and hospital stay, along with higher sepsis rates. Functional
outcomes, time to union, and early mobilization were significantly better in the ETC group.
Conclusion: DCO is essential for physiologically unstable patients, whereas ETC offers better functional recovery and reduced hospital burden
in stable polytrauma patients. A physiological status guided, individualized treatment approach is recommended.

A Prospective Comparative Study of Postoperative Complications and Visual Outcomes of Cataract Surgery in Uveitic Versus Non-Uveitic Eyes

2026-06-08T07:30:03+00:00

Background: Cataract is a leading cause of visual impairment, and uveitis is an important secondary cause of complicated cataract, particularly
in younger individuals. Cataract surgery in uveitic eyes poses significant challenges due to pre-existing inflammation and increased risk of
postoperative complications. Comparative evaluation with non-uveitic cataracts is essential to understand surgical outcomes and optimize
management strategies in tertiary care settings.
Aim: To compare postoperative complications and visual outcomes of cataract surgery in uveitic versus non-uveitic eyes in a Tertiary Care
Center in Gaya, Bihar.
Methodology: This prospective comparative observational study included 120 patients (120 eyes) undergoing cataract surgery over 12
months, divided into uveitic (n=60) and non-uveitic (n=60) groups. All patients underwent standard preoperative evaluation and cataract
extraction by phacoemulsification or SICS with intraocular lens implantation. Patients were followed up for 3 months. Outcome measures
included postoperative best corrected visual acuity (BCVA), intraoperative complications, and postoperative complications. Statistical analysis
was performed using SPSS version 25, with p<0.05 considered significant.
Results: Uveitic patients were significantly younger and had poorer preoperative visual acuity. Intraoperative difficulties, such as small pupil and
posterior synechiae, were significantly more common in uveitic eyes. Postoperative complications, including anterior chamber reaction, cystoid
macular edema, and posterior capsular opacification, were significantly higher in the uveitic group. Although both groups showed significant
improvement in BCVA, final visual outcomes were significantly better in non-uveitic eyes (p <0.001).
Conclusion: Cataract surgery in uveitic eyes provides significant visual rehabilitation but is associated with higher complication rates and
comparatively poorer outcomes than non-uveitic eyes. Careful perioperative inflammation control and vigilant follow-up are essential for
optimal visual outcomes.

A Study Comparing Shoulder Primary Adhesive Capsulitis Treatment with Arthroscopic Capsular Release, Subacromial Decompression, Rotator Interval Release and Manipulation Under General Anesthesia

2026-06-08T07:35:07+00:00

Background: Primary adhesive capsulitis is a painful and disabling condition of the shoulder characterized by progressive restriction of both
active and passive movements. Common operative options include manipulation under general anesthesia and arthroscopic capsular release,
often combined with subacromial decompression and rotator interval release.
Aim: To compare the clinical and functional outcomes of arthroscopic capsular release with subacromial decompression, rotator interval release
and manipulation under general anesthesia versus manipulation under general anesthesia alone in patients with primary adhesive capsulitis.
Methodology: This prospective comparative study included 40 adult patients with refractory primary adhesive capsulitis. Patients were allocated
into two groups: Group A underwent arthroscopic capsular release with subacromial decompression, rotator interval release and MUA, while
Group B underwent MUA alone. Patients were followed for a minimum of six months. Pain was assessed using the Visual Analog Scale, shoulder
range of motion was measured clinically, and functional outcomes were evaluated using the Constant–Murley score.
Results: Both groups showed significant postoperative improvement. However, group A demonstrated significantly greater pain relief, improved
range of motion in all planes, and higher Constant–Murley scores compared to group B (p < 0.05). Excellent to good functional outcomes were
observed in 85% of group A patients versus 50% in group B. Complication rates were low and comparable between groups.
Conclusion: Arthroscopic capsular release combined with subacromial decompression, rotator interval release, and MUA provides superior
functional outcomes compared to MUA alone in refractory primary adhesive capsulitis, with acceptable safety and reliability.

A Prospective Study Evaluating the Correlation of Body Mass Index, Waist–Hip Ratio, and Lipid Profile with Newly Diagnosed Type 2 Diabetes Mellitus Patients in Adult Population

2026-06-08T07:37:37+00:00

Background: Type 2 diabetes mellitus (T2DM) is a major public health problem characterized by metabolic disturbances, including obesity
and dyslipidemia. Anthropometric indices such as body mass index (BMI) and waist–hip ratio (WHR) are simple indicators of adiposity and
may correlate with lipid abnormalities, thereby predicting cardiovascular risk in newly diagnosed diabetic patients.
Aim: To evaluate the correlation of BMI, WHR, and lipid profile parameters in adult patients with newly diagnosed type 2 diabetes mellitus
attending a tertiary care center in Bihar.
Methodology: This prospective observational study included 100 newly diagnosed T2DM patients aged ≥18 years attending the outpatient
department. Anthropometric measurements, including BMI and WHR, were recorded using standardized methods. Fasting blood samples were
analyzed for lipid profile parameters, including total cholesterol, triglycerides, LDL, HDL, and VLDL. Data were analyzed using SPSS version
20. Pearson’s correlation coefficient and appropriate statistical tests were applied, with p <0.05 considered statistically significant.
Results: The majority of patients were overweight or obese, with a high prevalence of increased WHR indicating central obesity. Dyslipidemia
was common, characterized by elevated total cholesterol, triglycerides, LDL, and reduced HDL levels. BMI and WHR showed significant positive
correlation with total cholesterol, triglycerides, and LDL, and negative correlation with HDL. WHR demonstrated a stronger association with
lipid abnormalities than BMI.
Conclusion: BMI and WHR, particularly WHR, are reliable and cost-effective indicators for predicting dyslipidemia and cardiovascular risk
in newly diagnosed T2DM patients and should be routinely incorporated into clinical assessment.

Epidemiology of Dry Eye Disease in Adult Outpatients in Bihar: A Prospective Study Assessing Prevalence and Associated Risk Factors

2026-06-08T07:42:07+00:00

Background: Dry eye disease (DED) is a multifactorial ocular surface disorder characterized by tear film instability, ocular discomfort, and
visual disturbances. Globally, it is a common cause of ophthalmology outpatient visits, but regional epidemiological data from Bihar are limited.
Understanding prevalence and risk factors is crucial for early detection and management.
Aim: To determine the prevalence of dry eye disease and identify associated demographic, occupational, and systemic risk factors among adult
outpatients attending Anmmch Gaya , Bihar.
Methodology: A prospective observational study was conducted over nine months in the ophthalmology outpatient department of Anmmch
Gayaji. Adult patients (≥18 years) were randomly selected, excluding those with recent ocular surgery, active ocular infections, systemic
autoimmune disease, or incomplete data. Dry eye evaluation included Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up
time (TBUT), Schirmer I test, and corneal/conjunctival staining.
Results: Out of 430 participants, 144 (33.5%) were diagnosed with DED. Prevalence was higher in females (39.1%) and individuals aged >50
years (41.3%). Independent risk factors included female sex, age >50 years, prolonged visual display terminal use, and diabetes mellitus. Tear
film instability (TBUT <10 seconds) was the most common objective finding (81.9%).
Conclusion: DED is highly prevalent among adult outpatients in Bihar. Early recognition, risk factor modification, and targeted preventive
strategies are essential to reduce symptom burden and ocular surface morbidity.

Heavy Metal Deposition in Freefall Atmospheric Dust Under Meteorological Observation in Industrial City, Kota, India, Having a Coal-fired Thermal Power Plant

2026-06-04T10:52:26+00:00

This study was conducted to examine the concentrations of eight heavy metals (Zn, Cu, Pb, Cd, Cr, Ni, Fe, and Ca) in freefall atmospheric dust under the influence of meteorological conditions. Dust samples were collected during the winter season, from November 2024 to February 2025, in and around Kota, Rajasthan. The mean concentrations (mg/L) of Zn, Cu, Pb, Cd, Cr, Ni, Fe, and Ca were recorded as 4.3248, 0.7770, 1.5683, 0.1130, 1.0517, 0.8899, 77.4911, and 1666.42, respectively. The results indicate that the concentration levels of these metals are significantly affected by prevailing meteorological conditions during the study period, although some variations were observed, likely due to fluctuations in wind speed. Wind rose analysis revealed that sampling locations predominantly facing North-East and East wind blow (67.66%) from the Kota Thermal Power Plant exhibited the highest metal concentrations, as these sites are situated closest to the emission source. Furthermore, Pearson’s correlation and principal component analysis (PCA) suggest that Zn, Cu, Pb, Cd, Cr and Ni primarily originate from coal combustion processes at the Kota Thermal Power Plant, along with contributions from other industrial activities in the region.

Correlation between Glycosylated Hemoglobin and Glycemic Variability in Patients with Type 2 Diabetes Mellitus

2026-06-04T10:55:58+00:00

Background & Objectives: Glycosylated hemoglobin (HbA1c) is commonly used to diagnose and monitor diabetes. Still, it has some drawbacks, such as being affected by blood disorders and failing to show changes in blood sugar levels throughout the day. This study examined how HbA1c relates to measures of blood sugar variability, with particular focus on Time in Range (TIR).

Methods: We conducted a cross-sectional study of 70 patients with type 2 diabetes. We collected their HbA1c levels and data from continuous glucose monitoring (CGM). Using the ambulatory glucose profile, we measured glycemic variability, including TIR, Time Below Range (TBR), Time Above Range (TAR), and Mean Amplitude of Glycemic Excursions (MAGE). We then analyzed the relationship between HbA1c and these CGM metrics.

Results: HbA1c was strongly linked to TIR (r = -0.88, p < 0.001) and TBR (r = -0.29, p < 0.01) and also showed a strong positive link with TAR (r = 0.91, p < 0.001) and MAGE (r = 0.85, p < 0.001). Even though some patients had HbA1c below 7.5%, only 55.5% had TIR above 70%. Also, 60% had TBR above 4%, indicating many were at risk of low blood sugar.

Interpretation & Conclusions: While HbA1c remains helpful for assessing overall blood sugar control, it does not reflect changes in blood sugar throughout the day. CGM metrics, especially TIR, give a fuller picture and should be used regularly in diabetes care.

Awareness and Utilization of Ayushman Bharat Scheme Among Non-Medical Personnel in a Medical College Hospital in Bengaluru: A Cross-Sectional Study

2026-06-04T11:05:58+00:00

Background: Ayushman Bharat- Prime minister’s Jan Arogya Yojana (AB-PMJAY) aims to ensure financial security and improve access to specialized healthcare in India. However, gaps in awareness and utilization persist. This study assessed awareness, utilization and associated socio-demographic factors among non-medical personnel.

Methods: A cross-sectional study was carried out among 110 non-medical personnel in a medical college hospital in Bengaluru Rural District, Karnataka, from August to December 2025 using consecutive sampling. We used a pre-tested structured questionnaire as data collection tool which covered socio-demographic details, awareness, and utilization of AB-PMJAY. Awareness was scored and categorized as adequate (≥ 50%) or inadequate (< 50%). JAMOVI software version 2.7.17 was used to analyze data, like Descriptive statistics and Pearson’s Chi-square test.

Results: The mean age of participants was 34.69 ± 10.17 years. 52.7% had adequate awareness of AB-PMJAY. Most participants had heard of the scheme and knew the eligibility criteria; knowledge of specific benefits such as coverage amount was limited. Although 66.4% reported possession of an AB-PMJAY card in their family, only 8.2% had utilized its services. No significant association between socio-demographic variables and awareness was found.

Conclusion: Awareness of AB-PMJAY was moderate, but utilization was low, indicating a significant awareness-utilization gap. Strengthening targeted information, education, and communication strategies is essential to improve effective utilization.

Impact of Lid Margin Diseases on Tear Film Stability and Ocular Surface Parameters: A Prospective Controlled Study with Healthy Subjects

2026-06-08T07:43:33+00:00

Background: Lid margin diseases, including anterior and posterior blepharitis and meibomian gland dysfunction, are major contributors to
tear film instability and evaporative dry eye disease. Alterations in the lipid layer of the tear film disrupt ocular surface homeostasis, leading to
discomfort, visual disturbance, and epithelial damage.
Aim: To prospectively evaluate the impact of lid margin diseases on tear film stability and ocular surface parameters and to compare findings
with healthy controls attending at Anmmch Gaya, Bihar.
Methodology: This prospective controlled study included 200 participants over a 10-month period, comprising 100 patients with clinically
diagnosed lid margin disease and 100 age- and sex-matched healthy controls. All participants underwent a comprehensive ophthalmic examination,
tear film break-up time (TBUT), Schirmer’s test, ocular surface staining assessment, and ocular surface disease index (OSDI) scoring. Meibomian
gland morphology and expressibility were also evaluated.
Results: Patients with lid margin disease demonstrated significantly reduced TBUT and Schirmer values compared to controls (p <0.001).
Ocular surface staining and meibomian gland dropout were markedly higher among cases. A strong correlation was observed between disease
severity and worsening tear film parameters, along with increased symptom scores.
Conclusion: Lid margin diseases significantly compromise tear film stability and ocular surface health. Early diagnosis and targeted management
are essential to reduce disease burden and improve patient outcomes in tertiary care settings.