Abstract

Background: Knee osteoarthritis (OA) is a major cause of chronic pain and functional impairment. Corticosteroid (CS) injections provide short-term symptom relief but have limited long-term efficacy. Platelet-rich plasma (PRP) has emerged as a regenerative alternative with potentially sustained benefits.

Objective: To compare the efficacy and safety of intra-articular PRP and CS injections in patients with knee OA.

Methods: In this prospective randomised study, 70 patients with Kellgren–Lawrence grade II–III knee OA were allocated into PRP (n=35) and CS (n=35) groups. Baseline and follow-up assessments at 1, 3, and 6 months included VAS, WOMAC, and KOOS scores. Adverse events were recorded.

Results: Baseline characteristics were comparable between groups. Both PRP and CS groups demonstrated significant improvement in pain and function at 1 month. At 3 and 6 months, the PRP group maintained significantly greater improvement in VAS (2.9 vs 5.5 at 6 months, p<0.001), WOMAC (24.8 vs 45.9, p<0.001), and KOOS scores (75.9 vs 55.3, p<0.001). Adverse events were mild and self-limited.

Conclusion: PRP injections provided superior and sustained improvement in pain and function compared to corticosteroids in knee OA with a favorable safety profile. PRP may be considered a preferable non-surgical option in suitable patients.

Abstract
Background: Osteoarthritis (OA) is the most common degenerative joint disease, with the knee being the most frequently affected site. Although oral glucosamine and chondroitin have shown variable efficacy, intra-articular delivery may enhance local bioavailability and therapeutic response in early OA.

Objective: To evaluate the efficacy and safety of intra-articular glucosamine-chondroitin injections in early knee OA.

Methods: This prospective, randomized, double-blind, placebo-controlled pilot trial included 30 patients with Kellgren–Lawrence grade I–II knee OA. Group A received weekly intra-articular glucosamine sulfate (500 mg) plus chondroitin sulfate (400 mg) for 4 weeks; Group B received placebo. Pain (VAS), function (WOMAC), KOOS subscales, and adverse events were assessed at baseline, 1, 3, and 6 months.

Results: Baseline characteristics were comparable between groups. At 6 months, Group A showed significantly greater reductions in VAS (2.9 vs 5.2; p<0.001) and WOMAC scores (34.2 vs 44.5; p<0.001) compared to placebo. KOOS subscales (pain, ADL, symptoms, QoL) were also significantly improved in the intervention group (p<0.001 for all). No serious adverse events occurred; mild local reactions were self-limiting.

Conclusion: Intra-articular glucosamine-chondroitin injections produced significant and sustained improvements in pain, function, and quality of life in early knee OA with excellent safety. Larger trials with imaging endpoints are warranted to confirm potential disease-modifying effects

Abstract

Background: Osteoporotic fractures often demonstrate delayed healing due to impaired bone metabolism. Teriparatide, an anabolic recombinant human parathyroid hormone [PTH(1–34)], has shown potential to accelerate fracture healing. This study aimed to evaluate the effect of teriparatide on fracture union time, functional recovery, and safety in osteoporotic fractures.

Methods: A prospective, randomized study was conducted on 40 osteoporotic fracture patients at FH Medical College, Agra. Patients were randomized into two groups: Group A received daily teriparatide (20 μg) with calcium and vitamin D for 12 weeks; Group B received calcium and vitamin D only. Patients were assessed clinically and radiologically at 2, 4, 6, 12, and 24 weeks. Primary outcome was time to radiographic union; secondary outcomes were functional scores (Harris Hip Score, QuickDASH) and adverse events.

Results: Baseline demographics and fracture distribution were comparable between groups. Mean time to union was significantly shorter in the teriparatide group (10.2 ± 1.4 weeks) versus control (13.6 ± 1.8 weeks; p < 0.001). At 12 weeks, 85% of teriparatide-treated patients had union versus 45% in controls (p = 0.01). Harris Hip Score and QuickDASH showed greater improvement in the teriparatide group at 12 weeks (p < 0.05). Adverse events were mild (transient hypercalcemia, injection site reaction).

Conclusion: Teriparatide significantly shortened fracture healing time and improved early functional outcomes in osteoporotic fractures, with a favorable safety profile. It may be considered as an adjunct in selected patients, particularly those at high risk of delayed union.

Keywords: Osteoporotic fracture, Teriparatide, Fracture healing, Harris Hip Score, Randomized study

Abstract

Background: Osteoporotic fractures often demonstrate delayed healing due to impaired bone metabolism. Teriparatide, an anabolic recombinant human parathyroid hormone [PTH(1–34)], has shown potential to accelerate fracture healing. This study aimed to evaluate the effect of teriparatide on fracture union time, functional recovery, and safety in osteoporotic fractures.

Methods: A prospective, randomized study was conducted on 40 osteoporotic fracture patients at FH Medical College, Agra. Patients were randomized into two groups: Group A received daily teriparatide (20 μg) with calcium and vitamin D for 12 weeks; Group B received calcium and vitamin D only. Patients were assessed clinically and radiologically at 2, 4, 6, 12, and 24 weeks. Primary outcome was time to radiographic union; secondary outcomes were functional scores (Harris Hip Score, QuickDASH) and adverse events.

Results: Baseline demographics and fracture distribution were comparable between groups. Mean time to union was significantly shorter in the teriparatide group (10.2 ± 1.4 weeks) versus control (13.6 ± 1.8 weeks; p < 0.001). At 12 weeks, 85% of teriparatide-treated patients had union versus 45% in controls (p = 0.01). Harris Hip Score and QuickDASH showed greater improvement in the teriparatide group at 12 weeks (p < 0.05). Adverse events were mild (transient hypercalcemia, injection site reaction).

Conclusion: Teriparatide significantly shortened fracture healing time and improved early functional outcomes in osteoporotic fractures, with a favorable safety profile. It may be considered as an adjunct in selected patients, particularly those at high risk of delayed union.

Dental caries is one of the most common and enduring (chronic) diseases seen among children across the world, but particularly in India, where prevalence is high. Poor dietary habits, limited oral hygiene behaviors, and limited access to preventative dental services are strongly correlated with dental caries in children (particularly from socioeconomically poor region).  In this narrative review, we focused on the relation between increasing prevalence of dental caries in Indian children and the excessive consumption of sugary foods.  A systematic search of PubMed, Medline, and Science Direct identified ten peer-reviewed studies published within the last five years (2019-2023) on the consumption of sugary food and dental decay prevalence in various states in India.  All articles indicated that consumption of sugary foods (especially solid, sticky sweets) before bed and during their meals increases the likelihood of dental decay. additional contributing factors such as cultural practices that normalized high frequencies of sweet intake, a lack of health literacy, and reporting on a lack of oral hygiene education.  A social determinant of health was also identified as a significant risk modulator, such as poverty and limited access to dental care.   These results indicate the urgency in implementing appropriate, affordable, and culturally-specific interventions. These suggestions included the following potential interventions: school-based health education, sugar taxes, subsidized dental care for low-resourced communities, and culturally-relevant public awareness campaigns.  The article concluded that for tackling the ongoing childhood oral health crisis in India, and improving developmental outcomes, it requires a collaborative approach that engages multiple stakeholders.

Abstract: Background: Chronic diseases, including cardiovascular disease (CVD), diabetes, and neurodegenerative disorders, are major global health burdens. Oxidative stress and inflammation are central to the pathogenesis of these diseases. Personalized medicine, which tailors interventions based on genetic, environmental, and lifestyle factors, holds promise for more effective management of these diseases. This study explores the role of personalized therapeutic strategies targeting oxidative stress and inflammation in chronic disease management.

Objectives: To investigate the impact of personalized medicine on oxidative stress and inflammation biomarkers in patients with chronic diseases, and to evaluate the effectiveness of tailored interventions in improving clinical outcomes.

Methods: A total of 100 patients with CVD, diabetes, or neurodegenerative diseases were enrolled in this observational study. Participants underwent genetic profiling for common polymorphisms related to oxidative stress and inflammation (e.g., NRF2, TNF-α, IL-6). Lifestyle factors, including diet and exercise, were assessed. Personalized therapeutic interventions, including antioxidant (vitamin C, vitamin E) and anti-inflammatory treatments (curcumin, NSAIDs), were administered based on each participant's biomarker profile and lifestyle factors. Biomarker levels (MDA, 8-iso-PGF2α, oxLDL, TNF-α, IL-6, IL-1β) were measured before and after treatment, and clinical outcomes were assessed.

Results: Personalized medicine led to significant reductions in oxidative stress markers and inflammatory cytokines, with improvements in disease-specific clinical measures such as blood pressure, blood glucose, and cognitive function. The changes were more significant in the personalized treatment group compared to standard care.

Conclusion: Personalized medicine targeting oxidative stress and inflammation offers a promising approach to chronic disease management. Tailoring interventions based on genetic and lifestyle factors can enhance therapeutic efficacy and improve patient outcomes.

The “postnatal care" refers to the continuous medical attention given to the mother and her child. It helps ensure the short- and long-term health of the mother and child by assisting in the prompt detection and efficient treatment of postpartum problems. The research approach used for this study was quantitative non-experimental approach to accomplish the objectives of the present study. The research design selected for the study was descriptive research design because the present study was intended to assess the knowledge of nursing students. In the present study, a total sample of 47 nursing students, were selected using convenient sampling technique. The tool used to collect the data from the samples was self-structured interview schedule. The data were analysed using descriptive statistics. The demographic variables of the subjects were described using frequencies and percentages. The knowledge scores were assessed using mean, median and standard deviation. The study findings revealed that majority (63.8%) of the nursing students had moderately adequate knowledge scores and only 29.8% nursing students had adequate knowledge scores, whereas rest 6.4% of the subjects had inadequate knowledge regarding postnatal care.

Background: Chronic Obstructive Pulmonary Disease (COPD) is increasingly recognized not only as a respiratory disorder but also as a systemic disease with significant cardiovascular implications. Among emerging biomarkers, Brain Natriuretic Peptide (BNP) has shown promise in detecting subclinical cardiac dysfunction in COPD patients, yet its prognostic value in stable cases remains underexplored.

Objectives: To assess the prognostic utility of plasma BNP levels in stable COPD patients and evaluate their correlation with left ventricular ejection fraction (LVEF), valvular dysfunction, and spirometric parameters.

Methods: This cross-sectional observational study enrolled 120 spirometry-confirmed COPD patients aged 40–70 years from a tertiary care teaching hospital. All patients underwent pulmonary function testing, chest radiography, echocardiography, and plasma BNP estimation. Echocardiographic parameters included LVEF and severity of tricuspid, mitral, and aortic regurgitation. Statistical analyses included unpaired t-tests and Pearson correlations.

Results: The majority of patients were male (87.5%) and smokers (100%), with a mean BMI of 25.8 ± 2.3 kg/m². Reduced LVEF (<55%) was observed in 61.7% of cases. Valvular abnormalities were frequent, with tricuspid regurgitation present in 79% of patients. BNP levels were elevated (>100 pg/mL) in 78% of the cohort, with levels >1000 pg/mL associated with LVEF <50% and moderate-to-severe valvular regurgitation. A strong correlation was observed between reduced FEV₁/FVC ratios and declining LVEF. BNP levels significantly correlated with both echocardiographic findings and spirometric parameters (p < 0.05).

Conclusion: Elevated plasma BNP levels in stable COPD patients are strongly associated with impaired LVEF and valvular dysfunction, especially tricuspid and mitral regurgitation. BNP may serve as a non-invasive biomarker for identifying subclinical cardiac involvement in COPD, guiding risk stratification and management. Integration of BNP into routine evaluation may enhance early detection of cardiovascular complications in COPD populations.