Journal of Family Medicine and Primary Care

Bangladesh is experiencing emerging burden of Non-Communicable Diseases (NCDs). Non-communicable diseases (NCDs) are the emerging as major cause of morbidity and mortality, accounting for 61% of deaths in Bangladesh. The study aims to describe the prevalence of NCDs among pregnant women in teagardens in Moulvibazar district. Three teagardens of Sreemongol upazila in Moulvibazar district was selected randomly. The pregnant women were considered for collecting the NCD related information. A sample size of 86 was purposively selected based on relevant literature review. Data was collected by conducting face to face interview with the respondents through pre-tested semi-structured questionnaire. Data was analyzed with the help of SPSS Version 24 Software. For effective use of limited resources, an increased understanding of the shifting burden and better characterization of risk factors of NCDs including Hypertension is needed. Average age of the women attended for screening test was 23 (15-45) years. More than 47% women were found with Gravida 1. The mean duration of pregnancy was found 18.8 weeks. Above 24% percent of GDM women were found at low blood pressure but 2% were identified at high blood pressure. 28% were found underweight with BMI calculation but 11% were identified with overweight. The challenges tests for blood sugar findings of women were found 12.7% GDM positive (7.8-<11 mmol/L). About 16.5% had complications during pregnancy including anaemia, eclampsia, edema, diarrhoea etc. A community based NCDs surveillance model could be developed through participation Government health managers, experts and stakeholders, which were taken by local health system for implementation.

Background: Nursing documentation is an essential component of nursing practice that has a potential to improve patient care outcome. Poor documentation of nursing care activities among nurses has been shown to have negative impacts on the health care quality. The aim of this study was to assess documentation practice and associated factors among nurses working in Felege Hiwot comprehensive specialized hospital from August 1 to August 30, 2025. Method: Institutional based cross sectional study design was employed. The data was checked for completeness, coded and entered in epi -data version 3.1 and analysis was made by STATA version 14. Binary logistic regression analysis was computed to assess associations of factors with documentation practice. Variables with p- value less than 0.25 in Bivariable analysis was entered to final model and P < 0.05 at 95% confidence interval was considered as statistically significant. Odds ratio was used to show strength of association. Result: Out of the 349 respondents, 209 (59.9%) were females. In this study 40.1% of nurses had good documentation practice. Educational level, MSc (AOR, 95%CI; 10.3(3.4-31.8)), attitude (AOR, 95%CI; 2.6(1.5-4.7)), number of patient care (AOR, 95%CI; 5.6(1.9-16.3)) and Knowledge (AOR< 95%CI; 3.7(2.1-6.2)) were statistically associated with documentation practice. Conclusion and recommendation: Poor documentation practice was due to the identified factors. So, it is better to put further effort toward improving documentation practice through providing training on standards of documentation and enhancing the favorable attitude of nurses toward documentation practice. Keywords: Documentation, Nursing care, nursing record of patient care.

BackgroundConsanguineous unions are defined as the matrimony between individuals who are blood relatives. Researchers in all over the world worked on this issue and they checked the ratio of prevalence and effects of consanguinity in different regions of world. This research was conducted in the District Faisalabad, upper Punjab. ObjectiveTo find rate of consanguinity, coefficient of inbreeding (F) and its impacts. MethodsThe data was collected from six tehsils of District Faisalabad by interviewing the subjects. The data collected within the time span of six months. Total of 2366 subjects were interviewed after their consent approval. ResultsThe rate of consanguinity was noted 41.83% with 0.03053 coefficient of inbreeding. High rate of consanguinity (23.36%) was noted among first cousins. The distantly related and not related unions were 35.64% and 22.56% respectively. The rate of consanguineous unions in six tehsils ranged from 33.99% in Jaranwala to 53.85% in Tandlianwala. Consanguineous marriages were noted high in Punjabi speaking subjects, in housewives, in reciprocal marital types, in grand-parents and one couple family types and Rajpoot castes. There was found no significant differences of consanguinity in rural and urban areas. The rate of still births was noted high (82.25%) in consanguineous unions while neonatal, post neonatal and child mortality was low such less as 6.45%, 8.06% and 3.22% respectively. The prenatal mortality was noted slightly high 44.94% in consanguineous unions as compared to non-consanguineous unions. The congenital malformation rate was 6.29% in all marital unions but this rate was high (59.06%) in consanguineous unions as compared to non-consanguineous unions (40.93%). This is a pilot study to analyze the potential of inbreeding coefficient (F) in the District Faisalabad.

IntroductionHemophagocytic lymphohistiocytosis (HLH) is a serious condition induced by Dengue virus which becomes fatal if not detected early and treated appropriately. So objectives of the present study are to observe the different patterns of presentations, clinical features and outcome of HLH induced by Dengue. MethodsIn this observational study, 14 patients admitted and diagnosed HLH as per diagnostic criteria, were included after informed written consent. Study conducted in a period of six months from 01/07/2025 to 31/12/2025. All patients were followed up till discharge. After collection, all data were analyzed by Microsoft Excel 2010. Ethical clearance was taken from Ethical Review Board of the Medical College. ResultsAmong 14 cases, male were more affected then the female (78.6% VS 21.4%) and majority were in between 20 to 50 years age groups. Clinical data showed, all 14 cases had fever for >7 days, joint pain 3(21.4%), headache 11(78.6%), skin rashes 10(71.4%), retro-orbital pain 2(14.3%), vomiting 11(78.6%),bleeding 10(71.4%), cough 4(28.6%), loose motion 9(64.3%), abdominal pain 7(50.0%), anorexia 2(14.3%), Melaena 2(14.3%), jaundice 4(28.6%) and spleenomegaly 9(64.3%). One(7.1%) case had history of Hypertension. Laboratory data showed different level of Bi or Pancytopenia, high ferritin, high TG, low fibrinogen, raised liver enzymes and low sodium. Dengue RT PCR and serology results showed 8(42.9%) cases were both IG M and Ig G dengue antibody positive, 6 cases were RT PCR positive, 2 cases were IgM and another 4 cases were IgG positive. Outcome of patients revealed, among all 14 cases12(85.8%) patients improved uneventfully and 2 were shifted to ICU where one improved and one died. ConclusionDengue is prevailing for long time and different complications are evolving and HLH is a relatively newer incident among the dengue patients. Infection by different serotypes at different time or multiple dengue serotype infection may be related with HLH and it might be a future subject to explore and to evaluate.

BackgroundNon-communicable diseases are the result of a combination of genetic, physiological, environmental and behavioral factors. Evidence revealed that tobacco smoking is a leading cause of CVDs-related disability and premature mortality among others. Nevertheless, there is dearth of evidence on national and substantial health risks and distribution of health losses from CVDs associated with tobacco smoking in Ethiopia. MethodsData on mortality, disability-adjusted life years, years lived with disability, and years of life lost from CVDS attributable to tobacco smoking were extracted from the global burden of diseases 2023 study for Ethiopia and regions and administrative cities from 1990 to 2023. Comparative Risk Assessment Framework was used to generate the estimates. Disability-adjusted life years were obtained by adding the estimates of years lived with disability and years of life lost. Spatiotemporal Gausian process regression technique was employed to smooth the estimates. Rates were estimated per 100,000 population. ResultsAn estimated 98332.1 (95% UI: 81623.8, 116279.3) CVDs-related mortalities occurred among adults aged 20 years and above in Ethiopia in 2023. The corresponding age-standardized death rate of CVDs attributable to tobacco smoking was estimated to be 221.1 deaths per 100,000 population (95% UI: 182.1, 261.5). A higher than the national age standardized death rate was estimated in Afar [266.2 (95% UI: 205.1, 332.2)], Benishangul-Gumuz [268.3 (95% UI: 216.9, 321.3)], South west [334.9 (95% UI: 250.3, 459.7)], and Addis Ababa [342.8 (95% UI: 260.6, 418.6)]. The age-standardized rate was estimated to be 5317.8 disability-adjusted life years (95% UI: 4503.3, 6237.6), 375.9 years lived with disability (95% UI: 275.9, 488.9), and 4941.9 years of life lost (95% UI: 4152.4, 5809.5). Stroke and ischemic heart disease were found to be the leading causes of deaths attributable to tobacco smoking. There was no significant trend shift in all the rates from 1990 to 2023. ConclusionThis study has revealed that tobacco smoking continued to inflict substantial burden of disability and mortality among adults aged 20 years and above in Ethiopia, with subnational variation and stable trend over the past three decades. Ischemic stroke, ischemic heart disease, and intracerebral hemorrhage were found to be the leading causes of disability and premature mortality.

IntroductionAcinetobacter is a highly diverse genus which includes a range of common pathogenic species such as A. baumannii, A. lwoffii etc. Acinetobacter species causes bacteremia, pneumonia, wound infections, Urinary tract infections in community as well as hospital settings. A. baumannii is one of the ESKAPE pathogen which makes it even more lethal as antibiotics cannot action on this. AimTo isolate Acinetobacter species from various clinical samples and to check their antimicrobial susceptibility pattern by VITEK {square} Compact in SGT Hospital, Gururam, Haryana. ResultsOut of total 6673 samples 595 were the positive isolates from which 35 were Acinetobacter isolates which were received from various wards of the hospital. Occurrence of Acinetobacter was seen more in males(57.14%) as compare to females (46.8%). A total of 31 strains were A. baumannii, 3 were A. lwoffi and 1 strain was of A. haemolyticus. Prominent presence of Acinetobacter was seen in Blood (48.57%) specimen along with pus(22.85%), endotracheal (22.85%), tracheal (2.85%) and eye swabs (2.85%). All the isolates were resistant to piperacillin/tazobactam (100%), ceftriazone (100%), amikacin (100%), gentamicin (100%) ciprofloxacin (91.42%), ceftazidime (91.42%), cefepime (88.57%), levofloxacin (88.57%) and trimethoprim/sulfamethoxazole (80%). Colistin susceptibility was observed in 88.57% of the isolates. ConclusionAcinetobacter is a common pathogen in hospital acquired as well as in community acquired infections as it is a opportunistic pathogen hence to identify the Acinetobacter species and to understand their antimicrobial resistance pattern this study was conducted.

BackgroundThe COVID-19 pandemic significantly changed the daily routines of frontline health workers (FLHW), particularly those directly caring for COVID-19 patients. This study explores the lived experiences and coping strategies of FLHW at a Zonal Hospital in Kilimanjaro, Tanzania MethodThe study used a qualitative exploratory descriptive design, to retrospectively capture psychological impacts, challenges, coping strategies, and professional dilemmas faced by FLHW. Participants were purposively sampled from KCMC Hospital departments directly involved in COVID-19 patient care. FindingsThe FLHW experienced considerable fear, stress, and stigma. The fear of infection and high mortality rates among patients and colleagues heightened their anxiety. Stress was exacerbated by long working hours, uncomfortable personal protective equipment (PPE), poor remuneration, and the emotional toll of witnessing numerous deaths. FLHW also experienced being stigmatized and discriminated against, both within their workplaces, within the family and in the broader community. Some FLHW considered quitting their jobs due to the overwhelming workload, fear of being infected, and emotional strain. Additionally, absenteeism and avoidance of COVID-19 duties were common, driven by fear and inadequate hospital capacity. Coping strategies among FLHW to manage their stress and maintain resilience included acceptance, faith, family support, rest, and, the use of recreational substances. ConclusionThe FLHW experienced considerable fear, stress, and stigma. The study highlights the need for better psychological support, improved communication, adequate training, and resources to support FLHW before, during, and post-pandemic. Enhanced resilience and confidence, along with a greater appreciation for protective measures and compassion for patients, were some of the key lessons learned from their experiences during the pandemic informing more effective preparedness care in future pandemics.

Background: Chest tube infection is one of the complications of the tube thoracostomy. Infectious complications may develop in 2% to 25% of patients who undergo thoracotomy tube placement. The use of prophylactic antibiotics to prevent infections associated with thoracostomy tubes remains a subject of debate. Current practices in managing infections related to tube thoracostomy are hindered by the lack of comprehensive and localised data on the microbial profile and their resistance patterns. Objective: To determine the prevalence of thoracostomy tube infections and associated clinical characteristics among patients treated with a thoracostomy tube at KCMC Zonal Referral Hospital. Methodology: Prospective cohort study done at KCMC Zonal Referral Hospital. Include all patients undergoing thoracostomy tube insertion from September 2024 to April 2025. Results: A total of 84 patients underwent tube thoracostomy during the study time. Of these 22 (26.2%) developed SSI. Out of the 22 samples collected, 17 (77.3%) had positive culture results. The most commonly identified pathogens were Pseudomonas aeruginosa (41.2%) and Staphylococcus aureus (29.4%). The highest overall susceptibility was observed with amikacin, effective against 10 (58.8%) of the tested organisms. The most common resistance was observed against ceftazidime (56.3%) and piperacillin-tazobactam (50.0%). Prolonged chest tube duration (>7 days) was the strongest independent predictor of tube thoracostomy infection. Conclusion: This study revealed a high prevalence of tube thoracostomy infection. Prolonged tube duration and admission to a non-surgical ward care emerge as key risk factors for SSI. These findings underscore the importance of limiting chest tube duration when clinically feasible and ensuring optimal postoperative care environments to minimise the risk of infection.

Background Complementary and Alternative Medicine (CAM) contributes significantly to the utilization of healthcare services in mental health care in sub-Saharan Africa. However, there is limited evidence on the utilization of CAM in the particular setting of post-conflict northern Uganda. This study sought to establish the prevalence, forms, and socio-demographic determinants of CAM use among patients attending the Mental Health Unit at Gulu Regional Referral Hospital (GRRH). Methods This is a cross-sectional study conducted in a hospital setting from June to August 2025. Convenience sampling was employed to recruit 407 participants. A structured questionnaire was employed for data collection. Data analysis was done using STATA software version 18.0. Descriptive statistics were calculated, and bivariate analysis with Prevalence Ratios (PR) with 95% confidence intervals was employed to determine factors that are significantly associated with the use of CAM. Results The lifetime prevalence of CAM use was 63.4% (258/407), with 41.3% (168/407) using CAM currently. The most frequent CAM practices used were herbal medicine (50.4%), spiritual practices (33.7%), and traditional medicine (19.8%). For current users, spiritual practices were most frequent (88.7%). The reasons for using CAM were recommendations from others (84.8%) and cultural or religious beliefs (63.4%). Predictors of CAM use were primary education (PR = 1.36, p = 0.017), living in an urban area (PR = 1.23, p = 0.007), separated (PR = 1.39, p = 0.050), and having a mental health disorder for six or more months (PR range = 1.55-1.72). Catholics (PR = 0.72, p = 0.0007) and Protestants (PR = 0.76, p = 0.011) were less likely to use CAM than Born Again Christians. Conclusion The level of CAM use among patients accessing mental health services in GRRH of northern Uganda is significantly high, while the reporting of CAM use to healthcare providers is remarkably low. This is a challenge that requires urgent attention. Recommendations include integrating the use of CAM into medical practice, developing national policy guidelines on CAM, working in collaboration with traditional/spiritual healers, and conducting public education campaigns.

Emergency nursing is essential to healthcare systems worldwide. Triage plays a pivotal role in emergency nursing, prioritizing patients based on the urgency of their medical condition and focusing on rapid assessment and prioritization of patient care according to their condition and its severity. In the emergency department, the triage nurse assesses vital signs and gathers information from the patient to determine the severity of their condition. This aims to provide appropriate medical intervention quickly for life-threatening cases and minimize waiting times for less critical cases, thus contributing to the efficient allocation of scarce resources. Our study aimed to evaluate the triage knowledge, skills, and practices of emergency nurses in Mafraq, Jordan. MethodsA cross-sectional study used a previously validated questionnaire. Fifty emergency nurses from two public and one private hospital in Mafraq participated. We collected data through an online survey then analyzed in SPSS. Results92% of nurses had sufficient triage knowledge ([&ge;]60%), while 14% exhibited deficient triage skills (<60%) and 86% had moderate skills (60-80%). Regarding practices, 32% rated as "poor" (<60%) and 68% as "adequate" (>60%). Length working in emergency, hospital type significantly related to nurses triage knowledge, skills, and practices. ConclusionThe study underscores continual trainings, simulation programs and mentorships importance for enhancing emergency nurses triage knowledge, skills, especially in rural settings. Implementing clear triage protocols, continuous support and integrating triage competencies into curricula are recommended to improve overall triage competency

AimsThis study aimed to examine the prevalence of malnutrition and its associations with functional capacity and quality of life (QoL) in AL and ATTR cardiac amyloidosis patients. Methods and ResultsThis cross-sectional pilot study included 29 patients with confirmed CA (14 AL, 15 ATTR). Data were collected between January 2020 and September 2021. Nutritional status was assessed using body mass index (BMI), anthropometric measures, and the Subjective Global Assessment (SGA). Functional capacity was evaluated via handgrip strength and the 6-minute walk test, while QoL was assessed using the SF-36 and Kansas City Cardiomyopathy Questionnaire. Malnutrition, as determined by SGA, was present in 62% of patients, with no significant difference between AL and ATTR subtypes. In contrast, BMI according to WHO criteria failed to identify any cases of malnutrition, highlighting its limited utility in this population. These results suggest that conventional indicators may underestimate nutritional impairment in CA. Although overall QoL and functional capacity did not differ significantly between nutritional groups, malnourished AL patients showed notably lower QoL scores compared with well-nourished peers. ConclusionMalnutrition is highly prevalent in cardiac amyloidosis and seems to particularly affect the AL subtype. These findings underscore the importance of routine nutritional screening and targeted interventions, as early identification and management of malnutrition may improve patients quality of life and long-term outcomes.

BACKGROUNDSotalol loading intravenously enables achieving blood levels of sotalol that are observed at maximal steady-state concentration (Cmax ss) in one-day permitting the measurement of maximum QTc effects. Rapid evaluation of the QTc effects permits determination of arrhythmic risk and thus permits discharge in 24-hours instead of the usual three-day oral load hospitalization. Given the expense of IV Sotalol an oral loading test strategy is presented that also achieves Cmax ss blood levels rapidly, permitting a one-day hospitalization for QTc evaluation. METHODPharmacokinetic parameters referred to in the literature derived from normals as well as patients was utilized for population pharmacokinetic modeling and simulation.to obtain the Cmax ss concentrations for patients with normal renal function, creatinine clearance (CrCl) > 90 ml/min), as well as for patients with a CrCl of 60-89, 30-59, and 10-29 ml/min). Using pharmacokinetic simulations, an oral loading dose, as well as a second oral dose were determined that would reach the estimated Cmax ss in each of the groups based on renal function. RESULTSFor target dosing of 120 mg oral sotalol BID in patients with a CrCl >90 ml/min an oral loading dose of 200 mg provides a peak sotalol level of 1,420 ng/ml in 3-4 hours post dosing. The Cmax ss target is 1,299 ng/ml resulting in a 9% overshoot. The Cmax ss concentration provides a means of evaluating QTc effects within 24-hours. Oral loading regimens are described for varying additional renal function levels (CrCl 60-90, 30-59 and 10-29 ml/min) along with the time to first oral dose and follow-up dosing. The initial test dose can be based on an 80 or 120 mg oral sotalol maintenance dosing strategy. CONCLUSIONSEmploying an oral loading strategy may permit QTc evaluation and one-day discharge, preserving the pharmacoeconomic advantage of a Cmax ss test strategy. Clinical PerspectiveO_ST_ABSWhat is Known?C_ST_ABSO_LIIntravenously loading of sotalol enables achieving blood levels that are observed at maximal steady-state concentration (Cmax ss) in one-day permitting the measurement of maximum QTc effects. C_LIO_LIRapid evaluation of the QTc effects permits determination of arrhythmic risk and thus permits discharge in 24-hours instead of the usual three-day oral load hospitalization C_LI What the Study AddsO_LIWith oral sotalol loading, the Cmax ss can also be achieved in one-day permitting the measurement of maximum QTc effects and discharge from the hospital in 24-hours instead of the usual three-day inpatient initiation of oral sotalol. C_LI

Schizophrenia is a severe neuropsychiatric disorder characterized by positive and negative symptoms and cognitive impairments. The present study aimed to investigate the potential interference of ambient noise on the performance of executive function (EF) tasks in individuals with schizophrenia. The sample consisted of 40 participants, divided equally into two groups: a group of individuals with schizophrenia (SchG) and a healthy control group without neuropsychiatric disorders (HC). All participants did three EF assessment instruments: Trail Making Test, Corsi Block Test, and Maze Test. The experimental design included a test-retest procedure with order counterbalancing: half of the sample began the assessment in the noise condition and the other half in the no-noise condition, to control for order and learning effects. The results indicate that ambient noise has a negative impact on the cognitive performance of individuals with schizophrenia. Specifically, the SchG group performed significantly worse on the Maze Test in the noise condition compared to the no-noise condition. These findings contribute to the understanding of the interactions between sensory and cognitive processes underlying the symptoms of schizophrenia. In addition to their theoretical potential, the results have practical implications, as they support the development of intervention strategies and ambiental adaptations that can improve the functionality and quality of life of people with the disorder.

ObjectiveTo develop and conduct preliminary testing of the reliability and validity of the Healthcare Worker (HCW) Culture of Support Scale (COS), intended to assess health worker perceptions of institutional support resources and organizational culture related to their well-being. MethodsA cross-sectional survey was conducted with 533 HCWs from ambulatory clinic and rural hospital settings. The survey included validated measures and newly developed items. Exploratory and confirmatory factor analyses (EFA/CFA) were employed to determine the factor structure. Internal consistency and construct validity were assessed using Cronbachs and correlation with mental health outcomes. ResultsThe COS demonstrated a robust three-factor structure: 1) Organizational Support ( = 0.83), 2) Access to Peer Support ( = 0.92), and 3) Availability of Support ( = 0.97), accounting for 84.9% of variance. Cronbachs alpha for the overall scale was 0.94. CFA confirmed excellent model fit (RMSEA =.049, CFI =.992). Higher COS scores correlated with lower burnout (r = -.47, p <.001) and anxiety (r = -.35, p <.001), and greater resilience (r =.30, p <.001). ConclusionPreliminary evidence suggests that the COS is a reliable and valid measure of HCWs perceptions of organizational support for worker well-being. This scale and the three subscales can provide healthcare institutions with a way to evaluate organizational initiatives to enhance worker well-being and workforce resilience. Further testing is recommended in diverse settings.

BackgroundFerroptosis has emerged as a promising therapeutic target in IRI. However, it remains largely unclear how and when this iron-dependent regulated cell death manifests during IRI. Therefore, we explored malondialdehyde (MDA), a byproduct of lipid peroxidation, and glutathione peroxidase 4 (GPX4), as a marker of redox capacity, in multiple IRI models. With this explorative study, we aimed to uncover MDA dynamics in renal and hepatic IRI, which could provide valuable insights for future internal studies. MethodsHistorical plasma and tissue samples from rat and porcine models of renal and hepatic IRI were selected based on varying conditions of ischemic injury, reperfusion and perfusion. MDA was measured using a colorimetric assay with N-methyl-2-phenylindole, methanol, acetonitrile and hydrochloric acid and quantified at 595 nm. GPX4 protein concentrations were investigated using standard western blotting. ResultsIn rat clamping models, plasma MDA concentrations revealed no difference between control and IRI settings. However, an increasing trend could be observed in tissue samples after IRI. Similarly, a decrease in tissue GPX4 concentrations was observed after IRI. In porcine studies, MDA concentrations were increased during reperfusion of kidneys exposed to prolonged warm ischemia and livers exposed to short periods of cold ischemia. Dynamic preservation could attenuate MDA concentrations. ConclusionWe found that MDA and GPX4 are affected within the first hours after reperfusion, stressing the need for early sampling in studies focusing on characterizing ferroptosis. Moreover, MDA dynamics during organ perfusion revealed an increased vulnerability of ischemic organs to lipid peroxidation and a potential protective effect of dynamic preservation. These preliminary results should be confirmed in studies focusing on ferroptosis characterization, as notable observations regarding sample age and storage conditions and experimental design limit the validity of this study.

Background: Spotted fever is caused by spotted fever group rickettsiae (SFGR) belonging to the genus Rickettsia. Transmission to humans is primarily via the bite of infected ticks. Being a vector-borne disease, the occurrence of spotted fever is related to factors that allow the vector to thrive. This spatio-temporal analysis gives an insight into the distribution of cases and correlation with seasonality. Methodology: A suspected AFI patient was considered spotted fever positive if either serology (ELISA/IFA) or molecular assay (Nested PCR/qPCR) was tested positive. Demographic data of confirmed cases were included for the analysis. Results: In the 18-year dataset, a total of 2153 suspected patients were tested for spotted fever, of which 516 (24%) were positive. On spatio-temporal analysis, Vellore district reported 39.9% of cases, Chittoor 38.8%, Tirupattur 12.5%, Ranipet 4.5%, and Tiruvannamalai 4.3%. Maximum spotted fever cases were reported between the months of September to March, with a peak in January. Children below 10 years and housewives were at risk of spotted fever. Conclusion: The findings of this retrospective analysis highlight the importance of considering spotted fever group rickettsioses in patients presenting with acute undifferentiated febrile illness, particularly children aged <10 years, from areas with higher spatial clustering, during or following the monsoon season.

Schizophrenia (SCZ) and type 2 diabetes mellitus (T2DM) are common comorbid disorders that severely impair patient prognosis and quality of life. This study aimed to explore the association between the methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism and MTHFR promoter methylation in patients with comorbid SCZ and T2DM. A total of 120 participants were enrolled from Liaocheng Fourth Peoples Hospital between January 2025 and June 2025, comprising 30 subjects in each of the four groups: SCZ group, T2DM group, SCZ-T2DM comorbid (SCZ+T2DM) group, and healthy control (CTL) group. Corresponding primers were designed for genetic analysis, and methylation-specific PCR (MSP) was performed to detect the methylation level of the MTHFR promoter. Genotype distribution of the MTHFR C677T polymorphism was consistent with Hardy-Weinberg equilibrium (HWE) (p>0.05). The C677T polymorphism was significantly associated with an elevated risk of SCZ and T2DM comorbidity (p<0.05). Notably, the methylation rate of the MTHFR promoter in the SCZ+T2DM group (95.00%) was not significantly higher than that in the CTL group (90.00%) (p>0.05). In conclusion, the MTHFR gene may serve as a susceptibility gene for SCZ-T2DM comorbidity, whereas MTHFR promoter methylation is not associated with the pathogenesis of this comorbid condition. These results indicate that genetic variation in MTHFR, rather than promoter methylation, contributes critically to the comorbidity of SCZ and T2DM in the Han Chinese population. Our findings may provide novel molecular insights into their shared pathophysiology and inform future clinical strategies for patients with this complex phenotype.

Introduction: Rickettsial infections are vector borne diseases and seroprevalence shows regional and population based variation. This prospective study assesses the seroprevalence and factors associated with rickettsial infections in different geographical regions of Northern Tamil Nadu, India. Methods: A community based cross sectional study was performed among 2565 individuals in five districts in Tamil Nadu who consented and provided 4 ml blood samples. A semistructured questionnaire was administered to gather information on sociodemographic and environmental parameters. The serum IgG antibodies to scrub typhus (ST), spotted fever (SF), murine typhus (MT) and Q fever (QF) were detected by ELISA and the optical density (OD) recorded. EpiData was used for data entry and SPSS for analysis. Results: The seroprevalence of ST, SF, MT and QF was 14%, 9.1%, 3.7%, and 5.7%, among the study population. For ST, age >35, people living in rural and <1000 MSL, farmers, sleeping on the floor, lack of toilet at home, and grass near the home were associated with higher risk. For SF, people living at 501 to 1000 MSL elevation, no toilet at home and having pet animal were associated with higher odds. Females, 46 to 55 and >65 years, people residing in urban areas and elevation upto 500 MSL, those who sleep on the floor, not changing clothes daily and with pet at home were associated with higher odds of MT. Whereas Q fever was more likely to affect who sleep directly on the floor, residing in urban and do not have pets. Conclusion: Scrub typhus is the most common rickettsial infection followed by spotted fever in Northern Tamil Nadu. Factors associated with prevalence vary for different rickettsial diseases and include personal and lifestyle behaviors. The findings of this study need to be verified by multicentre cohort studies.

Introduction: Solitary plasmacytomas (SP) are rare neoplasm of localised proliferation of clonal plasma cells. It can be classified based on site of involvement and bone marrow involvement. It is an indolent disease in the majority of patients. Primary modality of treatment is radiotherapy and surgical excision. Materials and methods: This was a retrospective audit of SP who were treated and followed up at a tertiary care center in eastern India from January 2012 to December 2025. Patients who has solitary plasma cytoma with more than 10% plasma cells, POEMS syndrome, have been excluded from analysis. Results: We identified 46 patients of SP. The median age of the studied population was 53 years (23-75 years). Males were more commonly affected than females (M:F=2.2:1). Most common chief complaints were bony pain (67.4%). SBP was seen in 39 (84.8%) cases whereas SEP was seen in 7 (15.2%) cases. Vertebra was the most common site of involvement (61.4%). Median M band concentration 0.24 g/dL (0.1 to 1.95 gm/dL). IgG was the most common isotype accounting for 60.6% cases. Six cases (13%) had minimal bone marrow involvement. The majority of the patients received local radiotherapy (89.1%). With a median follow up of 5.4 years (95% CI: 1.8 - 9.0), median OS was not reached, median PFS was 9.22 years (95% CI: 5.8-12.6), median time to next treatment (TTNT) was 9.86 years (95% CI: 6.8 - 12.9). Conclusion: Solitary plasmacytoma commonly affects young males. Bones are more commonly affected than extramedullary sites. SP has a lower rate of progression and excellent prognosis when treated with local radiotherapy.

IntroductionDrug Induced Hemolytic Anemia (DIHA), following exposure to hematopathologically profound molecules, presents with variable clinical syndromes, misinterpreted serological results, misdiagnosis, challenging and controversial treatment; and no specific antihemolytic agent. Its treatment could be enhanced by use of natural molecules in some medicinal plants. Therefore, this study is aimed to determination the activities of aqueous extract of T. indica on PHZ-induced hematopathological changes in anemic male Wistar rats. Materials and Methods60mg/kg of Phenylhydrazine (PHZ) was administered for 2 days to induce hemolytic anemia intraperitoneally. 30 male Wistar rats were randomly divided into 5 groups, each with 6 rats. G1-untreated. Anemic rats were divided into G2- G5. G2-untreated, G3-treated with 1mL Ferro B syrup, G4 and G5 treated with 400mg/kg and 800mg/kg of T. indica pulp extract respectively. Test drug and extract were orally administered daily for 7 and 14 days respectively. Cases in G2 - G5 were sacrificed under light ether anesthesia on days 9 and 16 post-therapy, G1 at the end of the experimental period. Blood collected via cardiac puncture were subjected for Red Blood Cells (RBC) histopathology, serum Lactate Dehydrogenase (LDH), and reticulocyte counts. The femur was harvested for bone marrow Histopathology. ResultsPHZ induced hemolytic anemia marked by profound serum LDH elevation & reticulocytosis, marked RBC morphological distortions & bone marrow degenerative changes suggestive of marrow fibrosis & suppression. Marrow regeneration marked by hypercellularity & decreased adipocytes were evident of hematopoiesis induced by the 2 weeks test therapies; significant moderate populations of normal mature peripheral RBCs, serum LDH & reticulocyte % reduction were typical; consistent with significant recovery from the acute hemolytic episode. ConclusionT. indica fruit pulp extract effectively stimulated hematopoiesis in response to drug induced hemolytic effect on the hematopathologic parameters, with significant improvement from hemolytic anemia.