Rising global burden of anxiety disorders among adolescents and young adults: trends, risk factors, and the impact of socioeconomic disparities and COVID-19 from 1990 to 2021.

Background: Anxiety disorders are among the most prevalent mental health conditions globally, particularly affecting adolescents and young adults (10-24 years), and causing substantial psychological and social impairments. This study analyzed changes in the incidence, prevalence, and disability-adjusted life years (DALYs) of anxiety disorders in this age group from 1990 to 2021, emphasizing the impact of socioeconomic disparities and the COVID-19 pandemic, particularly post-2019.

Methods: Utilizing the Global Burden of Disease(GBD) 2021 data from 204 countries, this study evaluated global trends in anxiety disorders among adolescents and young adults.

Effectiveness of an Online Medical Spanish Course in Improving Medical Students' Spanish Proficiency.

Introduction: A growing need exists for language-concordant healthcare for Spanish speakers in the United States. More than three-quarters of American medical schools provide Spanish language instruction, but little data exists on best practices. The purpose of this retrospective study was to examine whether an online medical Spanish course is effective at improving medical students' Spanish proficiency.

Olfactory Evoked Potential Monitoring: Technical Note and Challenges Faced.

Background And Aim: Despite the sustained progress in the realm of intraoperative neurophysiologic monitoring of the nervous system, little progress has been achieved in monitoring the olfactory pathway. Loss of olfactory function due to retraction-induced physical damage during operations has ill-appreciated negative consequences for the patients and is often underreported. Improvements in this area of neuromonitoring require a revisit of the technical challenges.

Determinants of tumor necrosis and its impact on outcome in patients with Localized osteosarcoma uniformly treated with a response adapted regimen without high dose Methotrexate- A retrospective institutional analysis.

Purpose: Response to neoadjuvant chemotherapy in form of tumor necrosis predicts outcome in osteosarcoma; although response-adapted treatment escalation failed to improve outcome among patients treated with high-dose methotrexate-based (HDMTx) chemotherapy. This study aimed to identify factors predicting tumor necrosis and its impact on survival among patients with non-metastatic osteosarcoma treated with a response-adapted non-HDMTx regimen.

Methods: A retrospective single-institutional study was conducted among non-metastatic osteosarcoma patients treated with neoadjuvant therapy between 2004-2019.

Level V Metastases in Node-Positive Oral Squamous Cell Carcinoma: Beyond Level IIA and III.

Introduction: Surgical management of level V in clinically node positive (cN+) oral squamous cell carcinomas (OSCCs) is controversial. The objectives of the study were to identify predictors of level V metastases in cN+ OSCC.

Methods: This retrospective study is based on institutional data of operated cN+ OSCC between April 2018 and December 2022.

Effectiveness of Heart Failure Nursing Protocol (HF-NP) on quality of life of patients with heart failure.

Background: Effective management of heart failure (HF) requires an integrated approach involving pharmacological and non-pharmacological interventions. Available evidence shows that patients benefit from adjunctive therapies along with guideline-directed medical therapy (GDMT). Still, there is an inadequacy in the use of the best available evidence and the self-management of symptoms by the patients.

Molecular Characteristics of Community-Acquired Methicillin-Resistant , Hospital-Acquired MRSA Isolates, and PVL in one of the Indian hospitals.

Unlabelled: Community-acquired methicillin resistant (CA-MRSA) strains are increasingly replacing hospital-acquired MRSA (HA-MRSA) strains in hospitalized patients leading to poor clinical outcomes. Hence, this study aimed to characterize clinical isolates of MRSA (HA-MRSA and CA-MRSA) and to understand their clonal origin. A total of 400 consecutive clinical isolates were collected from the clinical bacteriology lab of a tertiary care hospital.

Endoscopic Monitoring of Treatment of Indeterminate Intestinal Lesions in a Prospective "Real-Life" Cohort in Eastern India Where Tuberculosis Remains Endemic: Distinguishing Intestinal Tuberculosis From Crohn's Disease.

Introduction It is sometimes difficult to differentiate between intestinal tuberculosis (ITB) and Crohn's disease (CD) in India, as both conditions may mimic each other. The aim was to differentiate ITB from CD in indeterminate intestinal lesions with a therapeutic trial of anti-tubercular therapy (ATT) and follow-up to find out the clinical, endoscopic, radiological, and histological predictors for differentiation between ITB and CD. Methods A prospective observational cohort study of patients diagnosed with ITB and CD according to the Asia-Pacific Guidelines in a "real-life" clinical setting was conducted.

Incorporating Climate Change Education Into Residency: A Focus on Community Risks and Resources.

Background: Graduate medical education (GME) focused on climate change (CC) health effects is essential. However, few CC education evaluations exist to guide residency programs looking to implement CC content.

Objective: To evaluate the effect of an education session on residents' self-reported knowledge of CC health effects and confidence utilizing local CC anticipatory guidance and community resources with patients.

A Rapid-Response Curricular Approach to Teaching Politically Charged Topics.

Residency education in the United States faces challenges from evolving external influence on evidence-based reproductive and gender-affirming health care (R/GAHC). Curricula must incorporate information and resources to assist residents in navigating changes. To illustrate a process for expeditiously adapting curriculum in response to changing laws affecting R/GAHC.

A Novel Longitudinal Training Experience in Obesity Medicine for Internal Medicine Residents.

Treatment of obesity is a public health priority. However, little training in obesity medicine is currently integrated into residency programs. We integrated a 12-month obesity medicine training experience within a New York internal medicine residency program.

Role of intestinal glucagon-like peptide-1 in impaired counter-regulatory responses to hypoglycemia.

Patients with type 1 diabetes mellitus (T1DM) experience multiple episodes of hypoglycemia, resulting in dysfunctional counter-regulatory responses with time. The recent experimental study by Jin explored the role of intestinal glucagon-like peptide-1 (GLP-1) in impaired counter-regulatory responses to hypoglycemia. They identified intestinal GLP-1 along with GLP-1 receptor (GLP-1R) as the new key players linked with impaired counter-regulatory responses to hypoglycemia in type 1 diabetic mice.

Comparison of Bioelectrical Impedance Analyser (BIA) with Dual-Energy X-ray Absorptiometry (DXA) Scan in Assessing the Body Composition of Adult Individuals with Type 2 Diabetes Mellitus.

Introduction: Assessing the body composition is important in adult patients with type 2 diabetes mellitus to prevent and achieve optimum control during treatment. Bioelectrical impedance analysis (BIA), being a more affordable method of assessing the body composition, should therefore be compared with the gold standard dual-energy X-ray absorptiometry (DXA) to look for a correlation between the two and the potential of BIA to be used widely in this population. A cross-sectional observational study was conducted on 60 patients attending the endocrinology outpatient department (OPD) of a tertiary care centre in Kolkata, India.

Association of Body Image Perception / (Dis)Satisfaction and Symptoms of Eating Disorders in University Students of Health Sciences.

We aimed to investigate the association of body image perception / (dis)satisfaction with eating disorders symptoms. We conducted a cross-sectional university-based study with 534 students, aged 18 years or older, from a federal higher education institution specializing in health sciences and located in Southern Brazil in 2023. We evaluated eating disorder symptoms using the Brazilian version of the SCOFF screening tool (≥2 symptoms) and body image using a silhouette scale developed for Brazilian adults.

Conventional Synthetic Disease-modifying Drugs Remain the Mainstay of Therapy for Rheumatoid Arthritis in India.

Background: There are limited data on the real-world utilization of disease-modifying antirheumatic drugs (DMARDs) in Indian patients with rheumatoid arthritis (RA).

Methods: This was a cross-sectional study of a multicentric observational cohort of RA patients across rheumatology clinics at six centers across India. Patients who met the American College of Rheumatology (ACR) 2010 criteria for RA were included.

Spontaneous transvaginal evisceration of small intestine in a case of long-standing uterine and rectal prolapse.

Spontaneous transvaginal small bowel evisceration, without recent trauma or surgery, is extremely rare. Complications include bowel obstruction, perforation, gangrene, septicaemia and death, requiring urgent surgical intervention. We report a case of a woman in her late 60s, who presented with 70-75 cm of small intestine eviscerated through the vagina, alongside a long history of uterine and rectal prolapse.

Contextual factors influencing bubble continuous positive airway pressure implementation for paediatric respiratory distress in low-income and middle-income countries: a realist review.

Background: Bubble continuous positive airway pressure (bCPAP) is a low-cost, non-invasive respiratory support therapy for children with respiratory distress, but its effectiveness is dependent on the context. We aimed to understand contextual factors influencing bCPAP implementation for children aged 1-59 months in low-income and middle-income countries (LMICs) and to develop a theory explaining how these factors influence implementation outcomes.

Methods: In this realist review, we generated an initial programme theory comprising candidate context-mechanism-outcome configurations (CMOCs) via review of key references and team discussion.

Efficacy and safety of Nusinersen among children with spinal muscular atrophy from North India: A prospective cohort study (NICE-SMA study).

Background: Intra-thecal Nusinersen has been approved for the treatment of Spinal muscular atrophy (SMA). Limited data is available regarding the efficacy and safety of Nusinersen in children with SMA type 2 and 3 from North India.

Objective: To study the efficacy and safety of Nusinersen among children with SMA type 2 and 3 from North India compared to standard of care (SOC) over 12 months.

Management of facial asymmetry assisted with digitally designed surgical guide for 3-dimensional maxillary repositioning: A case report.

Orthodontists play a pivotal role in diagnosing, planning, and preparing patients for orthognathic surgeries. Digital technologies like cephalometry, intraoral scans, CBCT scans, CAD-CAM-assisted 3-D planning, and printed surgical splints, have largely replaced conventional techniques. The automated software produces surgical splints with a design similar to conventional which may not address complex scenarios, involving symmetric and asymmetric maxillary impaction.

Unhindered Access to Hospital Buildings: A Neglected Domain.

Globally, 15% of the population suffers from disability. However, the percentage of people visiting hospitals who may be suffering from some form of disability may be higher. It may cause difficulty in accessing the health-care facilities.

Original Research: Exploring the Use of Passive vs. Active Insulin Safety Pen Needle Devices in a Pediatric Population: A Feasibility Study.

Background: Insulin pens are the mainstay of insulin delivery in the pediatric population, especially among patients unable to use an insulin pump. Safety pen needle (SPN) devices have been embraced by both nurses and patients because they limit the risks of needlestick injury and exposure to blood-borne pathogens. With the commonly used traditional passive SPN device, however, it can be difficult to observe that the dose has been accurately or fully administered.

Lumbar spine coronal balance parameters as a predictor of rehabilitation management outcomes in patients with radiculopathy due to lumbar disc herniation: A multicenter prospective case series study.

This prospective consecutive case series was conducted in 5 physiotherapy clinics in the UAE from January 2021-March 2023 to assess coronal lumbar spine radiographic parameters as a predictor of conservative therapy outcomes in patients suffering from low back and leg pain due to lumbar herniated nucleus pulposus (HNP). Ninety patients (mean age 44 yrs., 54 % male) with lumbar HNP underwent conservative therapy.

From Theory to Action: Evaluation of a Longitudinal Project-Based Antiracism Course for Post-Graduate Physicians.

Objectives: Few opportunities exist for postgraduate physicians to learn to address racism in their professional practice. We created a virtual, 5-session antiracism course that included the development of a formal action project to address racism at participants' home institution.

Methods: We delivered this curriculum virtually to 2 cohorts (2021 and 2022) of postgraduate physicians, nationally.

Arthroscopic Versus Open Bone Grafting and Internal Fixation of Scaphoid Nonunion-A Systematic Review.

Background: Scaphoid nonunion often requires surgical management involving the combination of a bone graft and internal fixation to restore the carpal alignment and length. While traditionally, the scaphoid waist nonunions have been treated with open bone grafts, with the advent of arthroscopy, bone graft reconstruction can now be carried out as an arthroscopic assisted minimally invasive procedure. We aimed to compare outcomes between open and arthroscopic bone grafting in the treatment of scaphoid nonunion.