Introduction: statins therapies are a cornerstone in the management of coronary artery disease (CAD), largely due to the prominent role of lipids and triglycerides play in the pathophysiology of the disease. HMG-CoA enzyme inhibitors are integral to the management of CAD Aim: the study aims to evaluate the real-world efficacy, adverse effect, symptoms, co-morbidities, and lipid profile of HMG-CoA enzyme inhibitors in CAD management. Methods: a meticulously designed prospective observational study was conducted on patients diagnosed with CAD, including acute coronary syndrome (ACS), Anterior Wall Myocardial Infarction (AWMI), unstable angina, myocardial infraction (MI). participants were stratified based on the prescribed HMG-CoA enzyme inhibitors. Key clinical endpoints, such as side effects, adverse effect, symptoms, co-morbidities, lipid profile and all-cause mortality were assessed over a structured 1-month follow-up period. Result: A total of 100 patients were enrolled. After 1 month of taking HMG-CoA enzyme inhibitors side effects, with muscle pain, weakness, headache, stomach pain the majority of recurring symptoms were observed in patients aged 41-80 years. The risk-benefit equilibrium of these agents underscores the necessity of precision medicine in tailoring statins therapy for CAD patients. Conclusion: HMG-CoA enzyme inhibitors integral to contemporary CAD management, with Atorvastatin and Rosuvastatin being most commonly used drugs in this disease. In this study, the adverse effects of statins are mild and transient. Fewer patients experienced sleeplessness after using these drugs, and overall, symptoms and side effects were relatively manageable. However, a significant portion of patients experienced side effects after taking HMG-CoA enzyme inhibitors in the management of coronary artery disease

Objectives: This study aimed to formulate and evaluate a functional probiotic ice cream using Lactobacillus spp. with high viability and nutritional integrity. The objective was to develop a palatable probiotic delivery system that maintains microbial stability and functional properties during refrigerated storage. Methods: A factorial design approach was employed to optimize the proportions of natural cream, milk, and honey to achieve desirable texture, flavor, and probiotic survivability. The selected Lactobacillus strain was isolated from curd and characterized using Gram staining and biochemical tests. The optimized formulation was assessed for pH, reducing sugars, protein, fat, and viable CFU count over a 20-day storage period at 4 ± 1°C. Results: The optimized batch maintained pH between 5.0–6.7 (Table 1), reducing sugar content ranging from 0.78–1.22 (Table 2), and protein levels between 0.20–0.54 (Table 3). Fat content averaged 10.8% (Table 4), and viable counts remained within 10⁷–10⁸ CFU/g (Figure/Table 5), meeting international probiotic standards. The formulation retained its physicochemical and nutritional properties, indicating successful optimization through factorial design. Conclusion: The study demonstrates that probiotic ice cream can serve as an effective and consumer-friendly vehicle for probiotic delivery. The formulation shows potential clinical relevance for improving gut health and supporting gastrointestinal wellness. Future in vivo studies are recommended to confirm colonization and functional efficacy, paving the way for clinical translation and commercialization.

Background: Anaemia describes a condition in which there is a reduction of haemoglobin concentration in the blood of an individual to a level below 11g/dl. Anaemia is very common after age 65 years, accounting for 4.2% to 28 when WHO criteria are applied in different gender and age groups. Dementia is a clinical syndrome that affects memory, thinking, behaviour and ability to perform everyday activity. Dementia is a growing public health problem and results in cognitive decline and behavioural problems that lead to impairment in activities of daily living. WHO in 2021 reported that more than 50 million people were living with dementia, and about 10 million new cases are detected every year. There is a paucity of data in the area of dementia research from Sub-Saharan Africa and Uganda. Many patients are undiagnosed clinically due to non-consideration of readily accessible laboratory blood biomarkers. The current study was performed on people lining with dementia attending Hospitals in Kampala, Uganda to assess and compare levels of erythrocytes, leucocytes and platelets with non-demented control group Using Haematological biomarkers may be useful in dementia diagnosis.

Objective of the study: A case-control study was conducted to assess some Haematological profile as possible diagnostic biomarkers of Anaemia among Dementia patients attending five selected referral Hospitals in Uganda.

Methods: A case-control study was conducted among patients presenting consecutively to the Neurology and Psychiatric clinics of Mulago National Referral Hospital (MNRH).Kampala,Uganda  and Kiruddu National Referral Hospital (KNRH) Kampala,Uganda between January to December, 2024. Seventy-eight (78) elderly patients aged fifty years and older diagnosed with dementia by a Specialist or Medical Officer were recruited as case subjects while Seventy-eight (78) cohort subjects age and sex matched with no history of dementia served as control. Social demographics, clinical and laboratory characteristics were assessed for both cases and controls. Questionnaires with close-ended questions and Dementia diagnostic tools (MMSE)and Blessed Dementia Scale (BDS) were distributed to participants to collect data. Ten millilitres (10 ml) of blood samples were collected aseptically from antecubital vein from participants into Sodium EDTA vacutainer bottles for assessment of Haematological parameters using Mindray autoanalyzer for Complete Blood Count (CBC) analysis. Quantitative data was collected and entered into a Microsoft excel spreadsheet and exported into STATA software version 14.0 for analysis. Descriptive statistics including frequencies, percentages, mean and standard deviation were used to describe the Social demographics of the cases and controls. P-values of <0.05 was chosen to be statistically significant.Fisher’s exact test and odd ratios were used to establish association of parameters with dementia. Confounders were ruled out by performing post-diagnostic checks like VIF (Variance Inflation Factors) to ensure that those that are highly collinear are eliminated.Ethical approvals were obtained from Mount Kenya University Ethical Review Committee (MKU/ISERC/3354) and St. Francis Hospital Research Ethics Committee (SFREC-2023-117).

Results: The findings in the present study revealed statistically significant differences (p<0.05) and very low values in the means of Haemoglobin concentration, RBC count, Haematocrit, MCV,MCH, MCHC, and RDW-SD when the case group was compared with the control group.

Conclusion: Based on the result obtained, decreased erythrocytes and RBC indices may be possibly involved in the pathogenesis of dementia.

Background: Femoral shaft fractures are common in the pediatric population, and the Titanium Elastic Nailing System (TENS) has emerged as a preferred surgical treatment option due to its minimally invasive nature and favorable outcomes. Objective: To assess the clinical and radiological outcomes, functional results, and complications associated with TENS fixation in the treatment of pediatric femoral shaft fractures. Methods: This prospective observational study included 60 children (38 males, 22 females), aged 5–15 years, who underwent TENS fixation for femoral shaft fractures at [Insert Hypothetical Tertiary Care Center Name and Location] between January 2020 and December 2023. Collected data included demographics, fracture type (AO/OTA classification), surgical details (nail diameter, entry point), radiological outcomes (union time, alignment), clinical outcomes (hospital stay, time to weight-bearing), and complications (infection, malunion, refracture, limb length discrepancy, hardware issues). Results: The mean age of the patients was 8.7 years (range: 5-15 years). Road traffic accidents (45%, n=27) and falls from height (35%, n=21) were the most common mechanisms of injury. According to the AO/OTA classification, the most frequent fracture type was 32-A1 (simple spiral, 40%, n=24). The mean time to radiographic union was 8.2 weeks (range: 6-14 weeks). Full weight-bearing was achieved at a mean of 4.5 weeks (range: 2-8 weeks) post-operatively. The mean length of hospital stay was 3.1 days (range: 2-6 days). The overall complication rate was 11.7% (n=7), including superficial pin site infection (5%, n=3), limb length discrepancy of >1 cm (3.3%, n=2), and delayed union (>16 weeks, 3.3%, n=2). No cases of deep infection, non-union, refracture, or nail breakage were observed. Conclusion: TENS fixation is a safe and effective option for most pediatric femoral shaft fractures, offering reliable union, early weight-bearing, and low complication rates. Optimal outcomes depend on proper patient selection and surgical technique.

Surgical Site Infections (SSIs) develop at the surgical site within 30 days of surgery, or within 90 days if prosthetic materials were used. Cesarean Section (CS), is one of the most common obstetric procedure performed, and also associated with an increasing rate of SSI, leading to longer hospital stays, higher costs, and additional burdens for mothers. With SSI rates varying from 3% to 20%, this study aimed to report the incidence of SSI, analyze the risk factors, identify the causative microorganisms, and assess antibiotic susceptibility and resistance pattern. The aim of the study is to determine the incidence of SSI post cesarean section , to identify the risk factors associated with SSI and also to identify the type of microorganisms present and to analyze their antibiotic susceptibility and resistance patterns.

Background: Obesity is a significant risk factor for cardiovascular diseases, often leading to abnormalities in lipid profiles and elevated blood pressure.  In obese individual, there is an excess accumulation of fat which imposes an extra burden on cardiovascular system. The study aimed to compare the lipid profiles and blood pressure parameters in obese and non-obese individuals to determine the association between these factors.

Methods: The study was conducted at Dept. of Physiology, Dinajpur Medical College Hospital, Dinajpur, Bangladesh from January 2023 to December 2023. A total of 100 participants were recruited for the study, with 50 participants in each group. Data collected on their lipid profile (total cholesterol, triglycerides, LDL, HDL) and blood pressure (systolic and diastolic). Obesity was defined using the Body Mass Index, with a BMI ≥30 considered obese. Data analysis was performed using descriptive statistics, t-tests, and chi-square tests to compare the differences between the two groups.

Results: The mean age of participants in the obese group is 45.2±10.4 years, while the non-obese group has a mean age of 42.3±9.5 years. Study included 100 patients, 50 obese and 50 non-obese. In the non-obese group, there is a slight majority of females (51.9%) over males (47.9%). Overall, the total sample comprises 48% males and 52% females. The obese group has a mean BMI of 32.1 ±3.5 kg/m², which falls above the obesity threshold of 30 kg/m². obese group higher systolic blood pressure (136.3±12.5 mmHg vs. 123.1±10.2 mmHg, p < 0.05) and diastolic blood pressure (88.4 ± 9.4 mmHg vs. 78.7 ±8.3 mmHg, p < 0.05) than the non-obese group. The results were statistically significant for both lipid profiles and blood pressure parameters (p < 0.05).

Conclusion: Obesity is strongly associated with adverse changes in lipid profile and elevated blood pressure. These findings underline the importance of addressing obesity as a modifiable risk factor for cardiovascular health.

Interstitial lung diseases (ILDs) are a diverse group of pulmonary disorders with significant morbidity and mortality. Idiopathic Interstitial Pneumonias (IIPs) represent a major subset, characterized by varying patterns of inflammation and fibrosis within the lung parenchyma. This study aims to assess the diagnostic role of conventional chest radiographs compared to high-resolution computed tomography (HRCT) in identifying ILDs, particularly IIPs. A cross-sectional observational study was conducted on 100 patients with suspected ILD, evaluating imaging findings, demographic patterns, and disease distribution. HRCT demonstrated superior sensitivity (90%) and specificity (70%) in detecting ILD compared to chest radiographs (84% accuracy). Among IIPs, usual interstitial pneumonia (UIP) was the most prevalent (46.55%), followed by non-specific interstitial pneumonia (31.03%). The study also highlighted the association of ILDs with age, smoking, and collagen vascular diseases. HRCT emerged as the preferred imaging modality, effectively differentiating ILD subtypes, identifying early disease manifestations, and guiding clinical management. The findings emphasize the necessity of HRCT for accurate ILD diagnosis, reducing the need for invasive procedures. This research contributes to the growing body of evidence advocating for HRCT as the gold standard in ILD evaluation, improving early detection and patient outcomes.

Prosthetic valve endocarditis (PVE) is an infection of the endocardial surface that occurs on parts of the prosthetic valve due to microbial infestation. It is the most severe form of IE with an incidence of 1 – 6% of patients with valve prosthesis (Delgado V et al, 2023). According to 2023 European Society of Cardiologists (ESC) guidelines for management of endocarditis early PVE (within 6 months of valve surgery) is class I indication of surgery with new valve replacement and complete debridement (Delgado V et al, 2023). Surgery is also an indication in patients presenting with cardiogenic shock and heart failure secondary to PVE. Despite early use of surgical approaches, the nature of redo procedures increase the rate of morbidity and mortality with an inhospital mortality rate of about 20 – 40% (Delgado V et al, 2023). According to the 2023 ESC statistics, eventhough surgery is the best treatment option for PVE, it is performed in only 70% of the indicated cases due to the complexities and extensive postoperative care associated with the same. This article presents management of a patient presenting with cardiogenic shock and heart failure secondary to prosthetic valve endocarditis.

Background: Bacterial vaginosis (BV) is a condition in which there is an imbalance in the normal vaginal flora, where Lactobacillus is replaced with mixed flora of aerobic, anaerobic and micro-aerophillic species.Bacterial vaginosis has been associated with adverse pregnancy outcomes. Likewise, aerobic vaginitis can cause perinatal complications.

Aims: This study is taken to determine the prevalence of vaginal dysbiosis(bacterial vaginosis and aerobic vaginitis)and its adverse pregnancy outcomes (maternal/fetal outcome) in pregnant women attending antenatal clinic in a tertiary care hospital in North India.

Design: Prospective cohort study

Materials and method: The prospective cohort study will be conducted on women attending the Antenatal clinic of a tertiary hospital. All obstetric and neonatal data covering antenatal events during course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth will be collected. Vaginal dysbiosis will be detected as per standard microbiological techniques.

Conclusion:The findings help to understand the importance of targeted interventions, effective prenatal and perinatal care, and addressing socioeconomic and parity-related disparities to improve maternal and neonatal health outcomes. However further studies to explore the underlying causes of these distributions and develop strategies to optimize health care delivery and outcomes are required.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint inflammation, leading to pain, stiffness, and functional impairment. Its etiology involves a complex interplay of genetic predispositions and environmental factors, such as smoking and obesity, which trigger inflammatory responses mediated by cytokines like interleukin-1β and interleukin-6. Recent studies emphasize the effectiveness of a "treat-to-target" (T2T) approach in managing RA, aiming for remission or low disease activity through regular monitoring and personalized therapy adjustments. Advances in treatment options, including Janus kinase inhibitors and biologic disease-modifying antirheumatic drugs (DMARDs), have shown promise in controlling disease activity and alleviating symptoms. In addition to conventional therapies, various medicinal plants have demonstrated anti-arthritis properties. Notable examples include Aconitum kusnezoffii (caowu), which contains anti-inflammatory diterpenoid alkaloids; Ligusticum chuanxiong (Chuanxiong Rhizoma), known for its antioxidant effects; and Tripterygiumwilfordii (Thunder God Vine), whose active component triptolide exhibits significant anti-inflammatory activity. Other plants such as Boswellia serrata, recognized for its boswellic acids, and Cinnamomum cassia, which contains therapeutic terpenoids, also show potential benefits. A comprehensive management strategy that integrates both conventional treatments and herbal remedies is essential for improving the quality of life for individuals living with RA.

Adenium obesum, commonly known as the "desert rose," is a succulent plant from the Apocynaceae family, native to arid regions of Africa and the Arabian Peninsula. Characterized by its striking appearance, with vibrant flowers and a swollen caudex, it is widely cultivated for ornamental purposes. Beyond its aesthetic appeal, the plant has a rich history in traditional medicine, with various parts used to treat ailments such as venereal diseases, skin disorders, headaches, and joint pain. This plant is known to contain bioactive compounds, including cardiac glycosides, flavonoids, and terpenoids, which contribute to its diverse pharmacological activities, including antioxidant, anti-inflammatory, antimicrobial, anticancer, and antiviral properties.

Recent scientific research has validated many of these traditional uses, demonstrating the plant’s therapeutic potential in modern medicine. Studies highlight its cytotoxic effects against cancer cells, significant antioxidant activity, and effectiveness in combating various pathogens, including bacteria and viruses. Additionally, the plant’s ability to act as an abortifacient, though historically utilized in some cultures, requires caution due to its toxicity, which is attributed to compounds in its milky sap.

This review synthesizes the available literature on the medicinal properties of Adenium obesum, exploring both traditional uses and contemporary scientific findings. It emphasizes the plant’s therapeutic potential and encourages further investigation into its bioactive compounds and mechanisms of action, which could lead to novel natural remedies or complementary therapies in modern healthcare.

This review investigates the potential of Frerea indica, a rare and endangered medicinal plant with a rich repository of bioactive compounds. Phytochemical screening revealed the presence of alkaloids, flavonoids, tannins, and saponins, known for their therapeutic properties. The results demonstrated significant hypoglycemic effects, attributed to the synergistic action of the plant’s bioactive constituents. The findings highlight Frerea indica as a potential source of natural antidiabetic agents and underscore its importance in drug development. However, the rarity of this species necessitates sustainable conservation strategies to enable further exploration of its medicinal properties.

Background: Anguish implies sensations of discomfort in the chest. Recently has been discovered manifestations of anguish in patients with psychiatric diagnosis. Also, conceptual confusions between anguish, anxiety, panic and fear has been observed. Objetives: This study analyzed the prevalence of anguish in patients with psychiatric diagnosis and differences in the presentation of psychiatric symptoms under thre presentation of anguish. Method: A sample composed of 100 patients from a large mental health care institucion in Brazil was recruited (mean age = 44.54 years). The sample comprised 69 (69%) women, 29(29%) men and 2(2%) transexuals. After comparing the mean age, no statistically significance was found (p=0,248). The age of the participantes composing the total sample ranged from 17 to 77 years. The sample’s education level was 42(42%) secondary or lower and 47(47%) graduates. As for marital state, 47(47%) participants were single, 32(32%) married, 13(13%) divorced, and 7(7%) widower. 1(1%) participant didn’t answer to this topic. To measure independent and dependent variables were used the following instruments: (a) Brief Symptoms Inventory, (b) Defensive Style Questionnaire-40, (c) Hospital Anxiety and Depression Scale, (d) Hamilton Anxiety Rating Scale, (e) State-Trait Anxiety Scale, and (f) Mini International Neuropsychiatric Interview. Results: Chi-square test showed significant association between anguish and gender (p=0,041), 31(79.5%) women had anguish compared to 7(17.9%) men and 1(2.6%) trans. Wilcoxon Mann Whitney test showed significant association between anguish and Brief Symptom Inventory (p=0,020). In this questionnaire online the variable somatization showed significance. Relatively to Hamilton Anxiety Scale, the variables fears, depressed mood, gastrointestinal and neurovegetative symptoms showed significance. Wilcoxon Mann Whitney and Chi-square tests showed that between anguish and depression variables somatization (p=0,02) and neurovegetative symptoms (p=0,018) and between anguish and anxiety only variable fears (p=0,018) was significant. Inferential analysis showed that depression is more linked to anguish than anxiety. Conclusions: As for the frst hypothesis, symptoms more related to anguish were somatization, fears, depressed mood, gastrointestinal and neurovegetative symptoms. Relatively to the second hypothesis, under the 82 participants with depression, 87.2% had anguish, while under the 69 participants with a diagnosis of anxiety disorders, 69.2% presented anguish, showing a greater frequency of anguish between patients with depression.