Abstract: Background: In the background of rising prevalence of non-communicable diseases (NCDs), the health system need to implement preventive strategies particularly at early stages of disease development. Addressing these issues should commence in childhood, as unhealthy lifestyle practices play a significant role in influencing health outcomes from an early age. Methods: This cross sectional study was conducted among1852 class eleven students in 15 Higher Secondary Schools in Thiruvananthapuram district selected through multistage cluster sampling. Dietary practices, physical activity and screen use patterns, substance abuse, and perceived stress levels were assessed using a prevalidated questionnaire. Blood Pressure, Anthropometric measurements, and Acanthosis nigricans neck severity grading were also recorded. Results: About 25% of the students had Grade I Hypertension and 8.3% had Grade II Hypertension. Around 19% of the students were overweight, while 6.4% were obese. Around 62% of the participants reported engaging in moderate or vigorous physical activities less than three days a week. Consumption of junk foods was highly frequent among the students, with 61% reporting consumption of oil-fried snacks three or more days a week and 53.5% consuming sugary snacks three or more days a week. Fruit and vegetable consumption was low. Acanthosis nigricans (neck) was found in 26% of the students. Nearly 33% of the students had recreational screen time greater than three hours per day. Conclusion: The study results show that a major proportion of middle-late adolescents have behavioural, and physiological risk factors for NCDs, warranting strong preventive measures to be adopted at school level itself. Strategies aimed at awareness generation, increasing availability of and accessibility to healthy food and physical activity habits, as well as regular anthropometric and blood pressure screenings with follow up provisions in the schools need to be implemented.
Key words: Adolescents, Diet, Physical Activity, Tobacco, Stress, Hypertension, Obesity

Abstract: Background: Visual inspection of plasma and platelet components is a crucial step in quality assessment at blood centres, enabling the identification of high-coloured plasma units. High-coloured units require further investigation through bilirubin testing. Normally, serum bilirubin levels range from 0.1-1.2mg/dl, with the majority being unconjugated (0.1-1.0mg/dl). Elevated bilirubin levels occur when systemic circulation bilirubin exceeds normal ranges, typically manifesting as jaundice at serum bilirubin levels ≥2.5mg/dl. Materials and Methods: This prospective observational study was conducted at the Department of Blood Transfusion Medicine, Government Coimbatore Medical College and Hospital. A total of 8,454 units were collected during the study period. Plasma and platelet component bags showing high-yellow coloration were included and subjected to serum bilirubin level estimation to detect hyperbilirubinemia. Serum total bilirubin levels >1.2mg/dl were considered significant. Results: During the seven-month period, 40 units (0.47%) exhibited icteric characteristics. All 40 icteric units tested negative for Transfusion-Transmitted Infections (TTI) screening. Further investigation revealed that elevated serum bilirubin levels were attributed to increased indirect bilirubin, predominantly unconjugated. Conclusion: Our study suggests that, despite lacking evidence of adverse effects from transfusing blood with highly coloured plasma, our institution will continue to discard such components until sufficient safety evidence emerges. Donors with isolated asymptomatic unconjugated hyperbilirubinemia should be referred for medical follow-up. Regulatory authorities should re-evaluate existing policies and consider incorporating serum bilirubin testing with defined cutoff limits into routine blood component screening.
Key words: Hyperbilirubinemia, High-coloured units, Serum bilirubin level, Plasma and platelet components.

Abstract: Oral cancer has been rising in alarming numbers in the world which is anticipated to escalate at 70% by 2030. Although a lot of factors are responsible for the disease, genetics, and gene mutations play a major role in uncontrolled proliferation. Another major factor is apoptosis which is programmed cell death. Apoptosis generally happens in two pathways Extrinsic pathway which involves trans-membrane receptor-mediated interaction and by Intrinsic pathway which is a mitochondrial-initiated event. There are Pro-apoptotic genes that support apoptosis like Caspases, TNF, and P53 families, and Anti-apoptotic genes like BCL-2 which stop the programmed cell death leading to cellular proliferation and tumor progression. This study was done to find the role of the anti-apoptotic protein BCL2 in varying histological grades of oral squamous cell carcinoma by immunohistochemistry.
Key words: BCL2, Immunohistochemistry, Apoptosis, Caspases

Abstract: Background: Workplace violence is a common phenomenon among health care workers. Nursing staff with shift duties tend to spend longer duration in hospital premises and hence are at higher risk. Objective: To assess the extent, perpetrators, mitigation strategies, reporting of WPV and predictors of workplace violence among nurses. Methods: A multicentre hospital based cross sectional survey among 511 nurses using a standard questionnaire was done. Descriptive and Logistic regression was used for analysis. Results: Among 511 participants 169 (33.1%) had experienced it wherein almost all (97.5%) experienced verbal violence, 75 (44.4 %) physical violence and 55 (32.5%) sexual violence. Perpetrators of violence in (26%) were patient’s relatives. Majority 153 (90.5%) expressed regular training of healthcare workers as mitigation strategy. A significant association using chi square was obtained between demographic variables as Age (Χ²= 13.181, p=0.04), Gender (Χ²= 8.675, p=0.013), Nature of duty (Χ²= 18.257, p=0.000), availability of Security Person (Χ²= 6.772, p=0.034) and types of WPV. The overall binomial logistic regression model for predictors of workplace violence was significant with χ2(5) = 29.53, p < 0.001, implying that age, type of hospital, nature of duty, working area are significantly associated. Conclusion and Recommendations: The WPV in various forms with verbal abuse being the commonest is prevalent among nurses in India. The healthcare administration needs to be sensitized so that firm policies and procedures can be planned and executed to ensure delivery of quality Nursing Care.
Key words: Workplace violence, Nurses, Predictors, Risk factors, Hospitals, Verbal abuse, Physical abuse, Sexual abuse.

Abstract: India currently has around 77 million adults living with diabetes. Considering the growing impact of diabetes-related complications, we aimed to compare the real-world prescribing patterns of sodium-glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors and traditional antidiabetics.Using a cross-sectional study design, the prescribing pattern and factors influencing the utilisation of the antidiabetic drugs, categorised by the HbA1c status, were assessed using the chi-square test. Of 260 eligible adults with mean [SD] age, 63.7[12.4] years; 54.7% of male participants initiated treatment with sodium-glucose cotransporter-2 inhibitors (n=27) or a dipeptidyl peptidase-4 inhibitors (n=31). The use of newer antidiabetic agents has steadily increased, with a slightly higher initiation rate in those over 65 years (21.5%). No significant difference was observed based on age (p = 0.182) or gender (p = 0.9548). Prescriber speciality had a significant impact (p = 0.00038). Cardiologists showed the highest shift towards newer drugs (36.5%). Prescriptions of newer antidiabetics have shown an upward trend over time, indicating a shift in prescribing practices. However, this increase was limited. Further efforts are necessary to identify and address the barriers to underutilisation of these drugs.
Key words: Dipeptidyl peptidase inhibitors, HbA1c, Prescribing pattern, Sodium glucose cotransporter 2 inhibitors, Type 2 Diabetes Mellitus.

Abstract: Errors in the administration of medications can have serious consequences and put patients' safety in danger Despite this, there remained a dearth of information on this topic in the south-east of Nigeria. This study aimed to identify the frequency, types, and factors linked to medication administration errors (MAE) among nurses working in tertiary institutions in south-eastern Nigeria. This cross-sectional study surveyed a total of 251 Nurses. The data were collected with a questionnaire and analysed using descriptive and inferential statistics. The mean and standard deviation were used for the 4-point scale items that assessed the influencing factors on MAEs and a mean (M) >2.5 was judged to be an influencing factor. Chi-Square test/Fisher's exact test were used to test for significant association between demographic characteristics and medication administration error at a 5% level of significance. The findings revealed that most (86.5%) of the respondents had administered medications incorrectly. The major nurse-related MAEs were a misidentification of drugs (2.71 ±1.00) and poor drug storage (2.70 ±0.90) were the major institutional factors. No significant association was found between medication administration error and the demographic characteristics: age (p = .376), gender (p = .647), rank (p = .067), working experience (p = .141), and highest academic qualification (p = .373). There is a high occurrence of MAEs among the nurses in this study. As a result, it should be a top priority to regularly provide training on medication safety procedures and updates on new guidelines
Key words: Medication administration error, Nurses, Factors associated with MAEs

Abstract: Objective: To identify independent risk factors and their odds ratio for behavioural problems in children with epilepsy. Methodology: This cross-sectional study involved children with epilepsy and matched controls. Epileptic children over 6 years old were selected through non-probability sampling. Children of the same age and gender who visited the pediatric outpatient department for minor ailments served as controls. Behavior was assessed using the Child Behaviour Checklist (CBCL). Pearson’s correlation examined the relationship between behavioral problems, seizure onset age, frequency, and drug therapy duration. Multiple logistic regression after adjustment for confounders like age, gender, maternal education, and socioeconomic status was done. The independent risk factors for behavioral issues in epileptic children were identified and odds ratios calculated. Results: Among 100 children with epilepsy and 100 controls, 44% of epileptic children had behavioral problems versus 20% of controls (P=0.001). Behavioral scores were significantly higher in epileptic patients across all CBCL domains (P<0.001). Only the anxious/depressed domain showed differences between children receiving anti-epileptic monotherapy versus polytherapy (P=0.025). Longer seizure duration (OR=2.4), longer antiepileptic therapy duration (OR=1.8), and higher seizure frequency (OR=2.1) independently predicted behavioral problems in children with epilepsy. Type of seizures (generalized tonic-clonic versus partial) did not predict behaviour problems (OR=0.8). Conclusion: Behavioral problems are not universal among children with epilepsy. Increased seizure frequency and duration are independent risk factors for these issues.
Key words: Behavioral problems, Children, Epilepsy, logistic regression, Seizure frequency

Abstract: Primary testicular follicular lymphoma (PTFL) is a unique extra-nodal variant of follicular lymphoma. It is commonly seen in children and young adults. They lack evidence of the BCL2 translocation, thus biologically differ from nodal follicular lymphoma. This report presents a case of PTFL in a 5-year-old boy characterizing, the clinical presentation and pathological features. The true incidence of PTFL is unknown owing to its rarity; nevertheless, about 25 cases have been reported in the literature so far. This would be one among the few cases reported worldwide of primary follicular lymphoma of the testis.
Key words: Follicular lymphoma, Non-Hodgkin Lymphoma, Testis, Primary Follicular Lymphoma

Abstract: Ganglioneuromas are rare benign tumors with favorable prognosis. Pancreatic ganglioneuromas are particularly uncommon, with only a few cases reported in the literature. Preoperative diagnosis can be challenging due to nonspecific radiological findings, difficult Fine needle aspiration (FNA) access, or inadequate sampling caused by the fibrous nature of the lesion. Surgical resection, followed by histopathological examination, remains the standard treatment approach. Herein, we report the case of a 65-year-old woman who presented with abdominal pain. Computed tomography (CT) suggested a diagnosis of lymphangioma or mucinous cystadenoma, but the final histopathological diagnosis confirmed the lesion to be ganglioneuroma. Hence, histopathology plays a significant role in accurate diagnosis of these lesions. Notably, to the best of our knowledge, this is the second reported case of pancreatic ganglioneuroma in the elderly population.
Key words: Ganglioneuroma, Enucleation, Pancreatic surgery, Pancreatic tumor, Retroperitoneal tumors

Abstract: Nasopharyngeal carcinoma is a locally invasive malignant tumor that invades the orbit frequently. We came across a 65-year-old man with locally advanced nasopharyngeal carcinoma on chemotherapy with orbital invasion causing total ophthalmoplegia, loss of corneal sensations, and ptosis. He also had a central neurotrophic keratitis with hypopyon. Based on these findings, a diagnosis of left-sided superior orbital fissure syndrome with neurotrophic keratitis was made. CT scan of the head revealed a soft-tissue mass abutting the superior aspect of the orbit and cavernous sinus and tumor recurrence was confirmed. We started the patient on topical fortified antibiotics and Atropine after placing a bandage contact lens. He was advised palliative radiotherapy by the medical oncologist. In two months, there was marked improvement in ocular motility, ptosis, and redness. The ulcer had healed by the formation of a central macular opacity. Corneal sensations had returned. This case exemplifies the reversible nature of superior orbital fissure syndrome and associated corneal anesthesia. As the tumor is radiosensitive, the mass effect of the tumor was reduced leading to the resolution of ophthalmoplegia and healing of the ulcer.
Key words: Neurotrophic keratitis, Nasopharyngeal carcinoma, Superior orbital fissure syndrome