Table of Contents : Journal of clinical and diagnostic research : 2025 - July - 19

Successful Iohexol Sclerotherapy for Non-parasitic Chyluria: A Case Report

Shashikant Asabe, Onkar Sangha, Vikram Satav, Vilas Sabale Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Chyluria is a medical condition characterised by the passing of milky urine due to the abnormal drainage of lymphatic fluid, known as chyle, into the urinary tract. This condition can result from a variety of aetiologies, both parasitic and non-parasitic, with Wuchereria bancrofti being the primary causative agent. Diagnosis includes clinical presentation, laboratory investigations, and imaging studies. Management encompasses a wide array of conservative therapies and surgical interventions. A 60-year-old male presented with chyluria and chyle clots for one year. He had received medical treatment for filariasis and dietary modifications at various hospitals before being referred to this centre. The patient was investigated and diagnosed with non-parasitic chyluria due to a left pyelo-lymphatic fistula and subsequently underwent sclerotherapy with Iohexol contrast, which resulted in complete resolution. This minimally invasive procedure involves the injection of a contrast agent that helps seal affected lymphatic vessels, preventing further chyle leakage into the urinary system. Severe chyluria can be effectively managed with Iohexol contrast sclerotherapy. This case underscores the importance of timely intervention and the use of sclerotherapy with Iohexol contrast as a treatment for severe chyluria, offering a promising therapeutic option for patients with persistent or complicated cases.

Fibroepithelial Polyp in the Oropharynx: A Case Report

Aishwarya Verma, Mohak Kumar, Paresh Chavan Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Fibroepithelial polyps are uncommon, benign hyperplastic lesions resulting from chronic irritation, typically found in the oral cavity but rarely in the tonsillar region. We present the case of a 21-year-old male with an 8-day history of a foreign body sensation in the right throat, insidious in onset and varying in intensity. The sensation was exacerbated by cold weather and spicy or oily foods. On clinical examination, a 1 cm soft, non-tender, fluctuant mass was identified in the right tonsillar fossa. Videolaryngoscopy corroborated the localised nature of the lesion, and a Computed Tomography (CT) scan of the neck and chest revealed no significant abnormalities. Given the benign presentation, surgical excision was performed using a tonsillar snare under general anaesthesia. Histopathological analysis confirmed a fibrovascular polyp lined by hyperplastic stratified squamous epithelium, with no evidence of malignancy. The patient recovered uneventfully post-surgery. Although rare in the tonsillar region, fibroepithelial polyps should be included in the differential diagnosis of benign oropharyngeal masses. Surgical excision remains the definitive treatment, with Histopathological Examination (HPE) essential for diagnostic confirmation.

The Domino Effect: Hyperventilation, Hypocapnia, and Tetany in Airway Management

Subha Teresa Jose Vazhakalayil, Sandeep Veer, Brinda Badam, Jayant Mane Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Airway management represents one of the most critical challenges in anaesthesiology, particularly in patients with history of head and neck surgeries due to altered anatomy. Routine procedures like tracheostomy can occasionally present with unforeseen challenges, demanding prompt adaptability. We describe a case involving a 60-year-old female with bilateral vocal cord palsy following thyroidectomy for Hashimoto’s thyroiditis four years ago. The patient had undergone a modified Dennis Kashima procedure, which involves injecting a bulking agent or placing a graft into the affected vocal cord to reposition it towards the midline, improving voice quality and airway protection in cases of vocal cord paralysis. The patient was tracheostomised for the first time under Local Anesthesia (LA) followed by Intensive Care Unit (ICU) stay for recovery two years ago and now came in for microlaryngoscopic biopsy under general anaesthesia in view of new onset persistent hoarseness of voice and progressive dyspnoea. The complication in our case arose due to repeated failed attempts in securing the airway, prompting anxiety and rapid breathing which in no time led to systemic complications like hyperventilation induced hypocapnia and hypocalcaemia which eventually landed patient to present with classical signs of tetany, supported by arterial blood gas analysis, confirmed hypocalcaemia (0.59 mmol/L). The condition was managed successfully with rebreathing using a Bain’s circuit and intravenous calcium gluconate, which restored patient stability. This case shows the importance of the anaesthesiologist in unpredictable airway management scenarios along with neutralising the systemic complications like hypocalcaemia a potentially life-threatening condition that can precipitate neuromuscular irritability, seizures, arrhythmias, and cardiac arrest, if left uncorrected at the same time. Preparation, teamwork, flexibility, and vigilant monitoring in such a difficult situation are far more elemental to the practice of true optimal patient care.

Anaesthetic Management of a Centrally Located Bronchial Carcinoid Tumour: Challenges in Airway Management and Perioperative Care

Shubhangi Humane, Dipti Rana, Shilpa Sarang Kore Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Bronchial Carcinoid Tumours (BCT) is a rare form of neuroendocrine tumours with severe anaesthetic challenges since they are centrally positioned in the bronchial tree, which can make them highly problematic in airway management. Even though they are commonly indolent, sometimes they may obstruct the airway, cause bleeding, or occasionally precipitate a carcinoid crisis. Hence, proper preoperative preparation is essential. We present a case report on the anaesthetic management of a 58-year-old female admitted for the removal of a BCT by wedge resection complicated by bronchial asthma. She had a centrally placed endobronchial tumour, as was evident from imaging. To facilitate one-lung ventilation by intubating her with a Double-Lumen Tube (DLT), we utilised a video laryngoscope and a paediatric bougie. A thoracic epidural was placed to provide optimal pain control in the perioperative period. Because of the extensive invasion of the tumour, planned wedge resection was converted into a pneumonectomy. Following surgery, she was extubated on the first postoperative day and made an uneventful recovery without a carcinoid crisis. To manage the complexity of resections for BCTs, this case stresses the versatility of advanced anaesthesia techniques and good perioperative care.

Combined Effects of Wall Squat and Treadmill Walking Exercises on Pain and Functional Disability in Non Specific Chronic Low Back Pain: A Case Report

Prem Jiteshkumar Shah, S Aravind Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Low Back Pain (LBP) is the most prevalent musculoskeletal condition worldwide, significantly affecting daily functioning and quality of life. It is mostly non specific in about 90% of cases, where there is no identifiable disease or structural reason to explain the pain. Physiotherapists play a key role in managing patients with chronic LBP. They use various strategies to alleviate pain, enhance pain tolerance, reduce stress on the lumbar region, strengthen lumbar stabilisers and improve functional abilities. Numerous studies have demonstrated the positive effects of isometric strengthening and aerobic exercise in chronic pain conditions. In this context, the authors present a case of a 22-year-old female patient, demonstrating the positive benefits of a combination of wall squat and treadmill walking exercises to improve pain and functional disability in a patient suffering from non specific chronic LBP.

Hereditary Dehydrated Stomatocytosis due to PIEZO1 Mutation and Potential Therapeutic Target for Sickle Cell Anaemia

Afaq Ahmad Khan, Santosh G Rathod Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Dear Editor, A 32-year-old female born out of a third-degree consanguineous marriage presented to the haematology clinic with generalised weakness, pallor, icterus, and pain in the left hypochondriac region. All these symptoms were for six months and progressive in nature. There was no history of similar complaints in other family members. On evaluation, the blood count showed: haemoglobin 9.9 g/L, red blood cell counts 3.37.000/mm3, white blood count of 7.1×109/L, platelets 128×109/L, Mean Corpuscular Volume (MCV) 98.3 fL, Mean Content Haemoglobin (MCH) 29.12 pg, Mean Corpuscular Haemoglobin Concentration (MCHC) 29.80 g/dL. Further evaluation revealed a total bilirubin of 2.4 mg/dL, indirect bilirubin of 2.1 mg/dL, Lactate Dehydrogenase (LDH) 1450 U/L, and haptoglobin of <8 mg/dL. The reticulocyte index on presentation was 9.0%, the electrolytes Na+ was 135 Meq/L, and the K+ was 4.5 Meq/L. The ultrasound of the abdomen showed splenomegaly 6 cm below the left costal margin. To find out the cause of haemolysis, we performed peripheral smear examination that showed numerous stmomatocytes anisopiokilocytosis, macrocytes, microcytes and spherocytes (Table/Fig 1). In order to rule out autoimmune haemolytic anaemia, Antinuclear Antigen (ANA), Anti-ds Deoxyribonucleic Acid (anti-ds DNA), and direct and indirect Coombs tests were performed, and they were all negative. The paraoxysmal nocturnal haemoglobinuria profile was found to be negative. We performed High-Profile Liquid Chromatography (HPLC), showing HbA2 at 5.3%, HbA at 73%, and HbF at 0.5%, ruling out haemoglobinopathy as the cause of haemolysis. Genetic tests encoding the beta and alpha globin chains ruled out structural modifications to haemoglobin. Enzyme activity related to red blood cell metabolism was normal. In order to rule out red blood cell structural defect as the cause of haemolysis, we performed the Eosin-5-Maleimide (EMA) test, which had a value within the normal range of 14% (normal test range >11%), ruling out the spherocytosis. This test is normal in all forms of stomatocytosis. Osmatic fragility test was negative in this patient.

The Silent Heart: Unveiling Mitral Stenosis in the Postoperative Period

Aparna Bagle, Rashmi Kelkar Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X To the Editor, Mitral Stenosis (MS) is a valvular heart condition marked by the narrowing of the mitral valve opening. The normal mitral valve area is 4-6 sq cm (1). While rheumatic fever is the most common cause, the stenosis generally does not become clinically important until several decades after the initial infection (2). It usually manifests 20 to 40 years after an episode of rheumatic fever and is more common in females (3). Common symptoms include orthopnea and paroxysmal nocturnal dyspnea (4). As the condition progresses, patients may also experience palpitations, chest pain, hemoptysis, and thromboembolism, particularly with an increased left atrial volume.

Impact of Preoperative Prism Adaptation Test and Patch Test Measurements on Surgery in Concomitant Horizontal Strabismus: A Prospective Interventional Study

Rahul Singh, Disha Chaudhary, Charu Sagar, Vandana Kohli Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: Concomitant horizontal strabismus poses significant challenges in achieving optimal surgical outcomes, with risks of undercorrection or overcorrection remaining a concern. Preoperative assessment techniques, such as the Prism Adaptation Test (PAT) and Patch Test, have been utilised to better estimate the angle of deviation and plan surgeries accordingly. The PAT is thought to refine surgical corrections by revealing the maximum angle of deviation. However, its specific impact on surgical outcomes-especially in comparison to the patch test-remains underexplored. Aim: To evaluate the impact of preoperative PAT and patch test measurements on surgical outcomes in patients with concomitant horizontal strabismus, focusing on their role in optimising surgical corrections and minimising postoperative undercorrection and overcorrection. Materials and Methods: This prospective interventional study was conducted over 15 months at Department of Ophthalmology, Employees’ State Insurance Corporation (ESIC) Postgraduate Institute of Medical Sciences and Research (PGIMSR), Basaidarapur, New Delhi, India, from October 2017 to February 2018 and included 30 subjects diagnosed with concomitant horizontal strabismus. Preoperative deviation measurements were obtained using the Prism Bar Cover Test (PBCT) at three distances: near (33 cm), intermediate (6 m), and far (12 m). These measurements were recorded both before and after a one-hour monocular occlusion (patch test). Following this, participants underwent the PAT. Based on their responses to these tests, subjects were categorised into three groups: non responders, patch test responders, and PAT responders. Surgical corrections were planned and performed using the maximum deviation identified by the PAT. Postoperative outcomes were assessed eight weeks after surgery using Hirschberg’s test and the Prism Alternate Cover Test (PACT). The study’s parameters included analysing preoperative and postoperative deviations, categorisation of test responses, and surgical outcomes. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 17.0, and a p-value of <0.05 was considered statistically significant. Results: The study included a total of 30 participants, comprising 18 males and 12 females, with a mean age of 20.83±12.03 years. Among them, 14 individuals presented with esotropia, while 16 exhibited exotropia. The study found that PAT significantly improved surgical outcomes. The actual residual deviation postsurgery ranged from 0 to 16? with PAT measurements, compared to an estimated range of 5 to 25? if surgeries were based on PBCT measurements before occlusion and 0 to 21? after occlusion. The mean residual deviation was lowest in PAT responders (6.8±6.07?) compared to patch test responders (8.5±6.09?) and non responders (11.5±7.09?) (p-value=0.02). Satisfactory alignment was observed in 90% of PAT responders, 80% of patch test responders, and 50% of non responders (p-value <0.04). Conclusion: The study concludes that the PAT significantly improves surgical precision and outcomes in patients with concomitant horizontal strabismus. By providing a more accurate assessment of deviation angles, the PAT reduces the risk of undercorrection and overcorrection compared to conventional preoperative measurements. These findings highlight the importance of incorporating PAT into preoperative evaluations to achieve optimal postoperative alignment and minimise residual deviations. The study underscores PAT’s value in enhancing surgical planning and outcomes, suggesting its routine use in clinical practice. Further research is warranted to evaluate its long-term effects on binocular vision and overall quality of life.

Ectopic Hidradenoma Papilliferum of Axilla: A Case Report

Purbasha Misra, Samarth Shukla, Rajesh Godavarthi Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X A benign adnexal tumour is a non cancerous growth located in the uterine tubes, ovaries, or near the uterus, including the surrounding connective tissue. While adnexal tumours can also be cancerous, they are predominantly benign. Moreover, adnexal masses can be non gynaecological, such as bladder diverticulum, appendicitis, apocrine gland tumours, sebaceous gland tumours, eccrine gland tumours and nerve sheath tumours. These tumours can occur at any age due to various causes. Some adnexal tumours are sporadic, while others may be linked to conditions such as Brooke-Spiegler syndrome and Birt-Hogg-Dubé syndrome. The tumours can be solid or fluid-filled and while some resolve spontaneously, others require therapy or surgical intervention. This case describes one such benign adnexal tumour: hidradenoma papilliferum, or papillary hidradenoma, which is a rare subcutaneous benign adnexal tumour of the apocrine glands in the anogenital regions. It typically occurs in females aged 30 to 50 years but is rarely reported in males. Hidradenoma papilliferum that is localised outside the anogenital region is referred to as ectopic. Ectopic presentations are primarily reported in the head and neck regions, especially on the external ear and eyelid, where modified apocrine glands are present. It is rarely reported in the nose, arm and axilla. This case report details a 53-year-old female who presented to the Surgery Outpatient Department (OPD) with a small swelling in her axilla accompanied by mild pain. Histopathological examination confirmed the nodular lesion as hidradenoma papilliferum. The location of the tumour was extremely rare and is often misdiagnosed as syringocystadenoma papilliferum and trichoepithelioma.

Knowledge, Attitudes, and Perceptions of Wet Cupping Therapy (Hijamah) among the Public in Northern Saudi Arabia: A Cross-sectional Study

Mohamed M Abd El Mawgod, Hassan Mohammad, Nawaf S Alenezi, Omar Mosab M Alenazi, Ashwaq Ibrahim H Alanazi, Taif Saleem Alanazi Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: Traditional medicine, particularly cupping therapy (Hijamah), is prevalent in both developed and developing nations, especially in the Kingdom of Saudi Arabia. Currently, it provides numerous health benefits, such as the prevention and treatment of various health problems including headaches, fatigue and bone aches. Aim: To explore the knowledge, perceptions and attitudes of the adult population in the Northern Border region of Saudi Arabia towards Hijamah. Materials and Methods: A cross-sectional study design was utilised among the adult general population in the Northern Border region of Saudi Arabia, between 1^st March 2024 and 30^th September 2024. A self-administered structured questionnaire containing questions about demographics, knowledge, attitudes and perceptions of Hijamah was employed. Qualitative data were presented as frequencies and percentages. Results: The study included 392 participants, whose mean age was 36±11.7 years. The majority of the participants believed that wet cupping is a helpful practice 367 (93.6%). Slightly less than 80% 303 (77.3%) accept it as an alternative therapy. The most frequently mentioned use of wet cupping is for fatigue relief 314 (80.1%), followed by headaches 299 (76.3%), back pain 270 (68.8%) and joint pain. Most people 328 (83.7%) agree that wet cupping remains a conventional therapeutic practice today. Conclusion: The majority of the adult population in the Northern Border Region understands the practice of Hijamah, accepts it as an alternative medicine, believes it has a favourable impact and commonly uses it to relieve fatigue, headaches and bone pains.

Circulating Endothelin-1 as a Diagnostic Marker in Patients with Acute Myocardial Infarction: A Cross-sectional Study

Anitha Rajendiran, S Sumathi, S Giridharan, V Kuzhandaivelu Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: The most common form of Coronary Heart Disease (CHD) is Acute Myocardial Infarction (AMI). When a coronary artery is blocked, it results in a substantial reduction in blood flow, which causes some of the heart muscle supplied by that artery to become infarcted. The development of Myocardial Infarction (MI) is regulated by a variety of complex processes. Vascular blockage and cardiac ischaemia may be exacerbated by endothelial dysfunction, platelet activation, and inflammation. Aim: To investigate the potential role of Endothelin-1 (ET-1) in the diagnosis of AMI. Materials and Methods: This cross-sectional research was carried out at Mahatma Gandhi Medical College and Research Institute in Pondicherry, India over the duration of one year (2023-2024) with a sample size of n=50 for the AMI group and n=30 for the healthy control group. Ethical clearance was obtained prior to the study. Upon admission, a 5 mL sample of peripheral venous blood was collected, centrifuged, and biochemical parameters such as glucose (random), urea, creatinine, and lipid profile were assessed using standard appropriate methods. The Enzyme-Linked Fluorescence Assay (ELFA) method was used to test troponin I, and the ET-1 immunoassay ELISA kit was utilised to quantify ET-1. Data were recorded and analysed using Statistical Package for Social Science (SPSS) Version 23 software. Categorical variables were analysed using the Chi-square test, whereas non-normally distributed continuous data were assessed with the Mann-Whitney U test. A Receiver Operating Characteristic (ROC) curve was plotted to identify the optimal cut-off value for ET-1 levels in patients with AMI. Bivariate correlation analysis was performed using the Spearman correlation test. Results: Serum ET-1 levels were significantly higher in AMI subjects compared to the control group (14.02±12.2 pg/mL vs. 3.1±2.8 pg/mL, p<0.001). The ROC curve analysis indicated that the serum ET-1 cut-off level was found to be 6.1 pg/mL. Additionally, serum ET-1 levels showed significant correlations with troponin I levels (correlation coefficient: 0.513, p=0.001). Conclusion: Elevated serum ET-1 levels at the time of admission were associated with higher troponin-I levels in patients with AMI. Hence, ET-1 can be a promising diagnostic marker for AMI assisting in early detection and prognosis.

Effectiveness of Tai Chi Exercise on VO₂max in Patients with Cancer after Chemotherapy: An Experimental Study

Seema Das, Somyata C Satpathy Sarma, Subarna Sankar Das, Trishna Kakati Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: Tai Chi, originally a Chinese martial art, is now recognised as an effective form of aerobic exercise beneficial for cardiac rehabilitation and mental well-being. It involves gentle movements, deep breathing, and relaxation, promoting body awareness and focus. Classified as a moderate-intensity exercise (2.6-6.5 MET), Tai Chi has shown clinical benefits, particularly for individuals with chronic conditions. Aim: This study aimed to evaluate the effectiveness of Tai Chi exercises by comparing baseline and post-exercise VO₂max scores in cancer patients after chemotherapy. Materials and Methods: A quasi-experimental study commenced in March 2022 and was completed in September 2022, affiliated with the College of Physiotherapy and Medical Sciences under Srimanta Sankaradeva University of Health Sciences, Guwahati, Assam, India. A total of 30 subjects were assessed, of whom sevenwere excluded, two declined, and 21 participated. After seven dropouts, 15 participants (aged 20-60 years, diagnosed with breast, stomach, or colorectal cancer) at stage II who had completed all doses of chemotherapy completed a 6-week Tai Chi programme (30-minute sessions twice a week). VO₂max was measured pre- and post-intervention. Demographic data (gender, height, weight, cancer type, chemotherapy doses, and vital signs) were considered. SPSS software version 25 was used, the Shapiro-Wilk test for normality was applied, and a paired t-test was conducted for parametric analysis, with statistical significance set at p<0.05, where p<0.001 was considered highly significant. Results: Fifteen post-chemotherapy patients participated in a 6-week Tai Chi programme. Pre- and post-programme VO₂max values were analysed using paired sample t-tests, with the Shapiro-Wilk test for normality. The sample consisted of 33% males and 67% females, with a mean age of 42.8 years (SD=8.41). VO₂max increased from a pre-exercise mean of 32.92 to a post-exercise mean of 36.64. Statistical analysis in SPSS version 25 showed significant improvement (p<0.001). Conclusion: The study indicates that a 6-week Tai Chi exercise programme significantly improves VO₂max in cancer patients post-chemotherapy, suggesting its potential as an effective rehabilitative intervention for enhancing cardiovascular fitness and overall well-being in this population.

Trimester Specific Effect of Pregnancy on Maternal Cognitive Function using Critical Flicker Fusion Frequency: A Cross-sectional Study

J Roshni, S Anu, M Ramji Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: Critical Flicker Fusion Frequency (CFFF) measures cognitive function by detecting the threshold at which flickering light appears steady. This threshold reflects neural processing and cortical arousal, making it useful for diagnosing conditions like Alzheimer’s and schizophrenia. During pregnancy, hormonal fluctuations can cause cognitive symptoms (“pregnancy brain”). Monitoring cognition ensures safety, productivity, and early detection of complications like pre-eclampsia. Despite importance, CFFF research during pregnancy is limited, especially across trimesters. Aim: To find out objective cognitive changes in various trimesters of pregnancy using CFFF in primigravid women and compare with non pregnant women. Materials and Methods: The present observational cross-sectional study was conducted from October 2023 to March 2024 in the Department of Physiology of Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India. The study involved 155 primigravid women in various trimesters and 50 non pregnant women in the age group of 21-25 years. The subjects were categorised into three groups. Group A- 1^st trimester group with Gestational Age (GA) between 0-13 weeks, Group B - 2^nd trimester group with GA between 14-27 weeks, Group C- 3^rd trimester with GA between 28-40 weeks. CFFF was measured in all these groups and the association was analysed. CFFF was measured with CFF M1 model instrument (Mavom Labs, Bangalore) using Netra software. Data were statistically analysed by using Chi-square test. Results: The study included 53 pregnant primigravid women in the 1^st trimester, 51 in the 2^nd trimester, 51 in the 3^rd trimester, and 50 non pregnant samples of similar age, marital status and with the average husband’s income of 42,261.29 with significant variability (SD=28,048.74). A significant decrease in CFFF values were observed in 1^st (p-value <0.001) and 3^rd (p-value <0.001) trimesters in pregnant women when compared to non pregnant individuals. The 2^nd trimester showed a significant increase in CFFF (p-value <0.001). Conclusion: The CFFF measurements could provide a useful tool for identifying individuals at risk of more severe cognitive decline or sensory processing difficulties during pregancy and take appropriate measures.

Evaluating Objective Structured Practical Examination as a Formative Assessment Tool in Biochemistry: A Cross-sectional Study from a Medical College in Telanagna, India

Amtul Rahman Amberina, Ravirala Tagore, B Ramya Sree Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: National Medical Council (NMC) advocates for Competency-Based Medical Education (CBME). This learner-centred curriculum emphasises continuous assessment that measures competencies and provides feedback. Objective Structured Practical Examination (OSPE) provides an improved objectivity and reliability than conventional assessment method. Thus, the present study was focused to assess cognitive as well as psychomotor domains in 1^st-year medical students by implementing modified OSPE. Aim: To evaluate OSPE module for the comprehensive assessment of both theoretical knowledge and practical skills among Phase 1 medical students in biochemistry, and to evaluate students’ perception of the OSPE through a structured questionnaire. Materials and Methods: This prospective, interventional cross-sectional study was conducted from November 2024 to January 2025 in the Department of Biochemistry at Mahavir Institute of Medical Sciences, Vikarabad, Telangana, India. A total of 126 students were recruited for the study after obtaining institutional ethical clearance (IEC No: 226/OCT/2024). All the students were taught about diabetes mellitus and estimation of Random Blood Sugar (RBS); the procedure was recorded and the video was shared with students through WhatsApp. OSPE stations were organised to estimate the RBS values and students were assessed using a prevalidated checklist. The student feedback on OSPE was solicited through a standardised questionnaire and analysed using Statistical Package for the Social Sciences (SPSS) software version 20.0. Results: All 126 students (100%) agreed that the OSPE instructions were clear and that the procedural video was helpful. A majority, 120 (95.2%), found the time allotted to be sufficient, while 6 (4.8%) did not. Similarly, 120 (95.2%) students confirmed that the OSPE questions were covered in lectures, and 123 (97.6%) students felt that the OSPE was well organised. Overall, 124 (98.4%) students reported that the OSPE was a valuable learning experience and supported conducting similar sessions regularly. The reliability score was 0.94. The student’s performance was very good, with 125 (99.2%) students scored more than 80% in procedure station and more than 75% in response station. Conclusion: The performance of students in the OSPE was very good, as most students scored good marks and their perception towards OSPE was more positive and opted to conduct regularly. So, the OSPE can be used as an assessment tool in formative assessment.

Birth Preparedness and Complication Readiness among Adult Males in Chengalpattu District, Tamil Nadu, India: A Cross-sectional Study

Vaishnavi Nagarajan, Aamina Hussain, VV Anantharaman Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: The active participation of males is vital for enhancing maternal and child health outcomes. Supporting mothers in timely healthcare decisions ensures better access to services and care. The World Health Organisation (WHO) defines maternal mortality as deaths caused by pregnancy-related complications or their management within 42 days of pregnancy termination, excluding incidental causes. Birth Preparedness and Complication Readiness (BPCR) is intended to reduce the three primary delays that lead to maternal mortality: delays in recognising the need for medical care, reaching a healthcare facility and receiving timely and proper treatment. Aim: To assess males’ levels of BPCR and identify the factors that influence their participation in these critical aspects of maternal health. Materials and Methods: A community-based cross-sectional study was conducted in Chengalpattu district of Tamil Nadu, India. The research work was carried out from December 2024 to February 2025. The sample size was calculated as 412, and at the end of the data collection, through simple random sampling, 420 samples were collected. Eligible participants were males aged 18 years and above. After obtaining ethical clearance, data collection was carried out using a validated questionnaire adapted from the Johns Hopkins Programme for International Education in Gynaecology and Obstetrics (JHPIEGO) questionnaire devised by The Maternal and Neonatal Health Programme, affiliated with Johns Hopkins University. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 26.0. Descriptive statistics, Chi-square tests, and logistic regression (both bivariate and multivariate) were applied to assess associations among variables. A p-value of <0.05 was considered statistically significant. Results: Among the 420 individuals, 193 (45.95%) were in the 30-39 years age group. Most participants (267, 63.57%) were first-time fathers. Commonly recognised danger signs during pregnancy include nausea and vomiting and severe headaches, which were recognised by 341 (81.2%) and 249 (59.3%) participants, respectively. Multivariable analysis revealed that cultural influence on decision-making was a statistically significant predictor of BPCR, influencing male participation in maternal health planning (AOR=0.091, 95% CI: 0.057-0.143, p-value <0.001). Conclusion: The study infers that early and informed male involvement in BPCR significantly enhances maternal health outcomes, emphasising the need for targeted awareness and engagement strategies.

Efficacy of Gunja Beeja Ointment versus Diclofenac Sodium Ointment in the Management of Avabahuka (Frozen Shoulder): A Research Protocol for a Randomised Controlled Trial

Shreya Parkhi, Sadhana Durgaprasad Misar Journal of clinical and diagnostic research : 2025 - July - 19:0973-709X Introduction: primarily caused by vitiated Vata affecting the Amsa Sandhi, manifests as shoulder dysfunction. Acharya Sushruta, categorise Avabahuka as a Vata Vyadhi, recommending Vatavyadhi Chikitsa. Symptoms include loss of upper limb movement, pain, and shoulder joint stiffness. In modern medicine, Avabahuka is analogous to Frozen Shoulder or Adhesive Capsulitis, impacting 2-5% of people in general and 10-15% of diabetics. Charaka Samhita recommends Lepa (paste) for immediate relief. Need of the study: The modern treatment includes analgesics and local intra-articular injections of corticosteroids, and physiotherapy. Nonsteroidal anti-inflammatory drugs have side effects such as nephrotoxicity, infectious arthritis and cartilage damage. There is a need for a safe and effective Ayurvedic herbal drugs which can be beneficial in such cases. Gunja Beeja contains Abrin and Abralin that has analgesic, anti-inflammatory and antimicrobial activities. No randomised controlled trial has been conducted on Gunja Beeja ointment in Avabahuka. Aim: To evaluate the efficacy of Gunja Beeja ointment versus diclofenac sodium ointment in the management of Avabahuka (Frozen Shoulder). Materials and Methods: This single-blind, parallel randomised controlled trial will take place over a period of one and a half years (February 2025-January 2026) at the Mahatma Gandhi Ayurved College Hospital and Research Centre (MGACH & RC), Salod (H) Wardha, Maharashtra, India. The study registered under CTRI/2024/07/070559 involves 60 patients meeting the inclusion criteria, randomly assigned into two groups of 30 each. Group 1 will receive Diclofenac sodium ointment while Group 2 will receive Gunja Beeja Ointment with shoulder exercises in both groups, once daily for seven days. Assessments will be conducted on days 0, 7, and 14, with follow-up on day 14. Outcomes will be measured using range of shoulder movement (Goniometer), pain (Visual Analogue Scale), stiffness (scoring method), muscle atrophy (measured in centimeters), and the Disability of Arm, Shoulder, and Hand (DASH) questionnaire.