European Journal of Cardiovascular Medicine

Background: Although various studies demonstrate a positive relationship between vitamin- A supplementation and decreased mortality and morbidity rates from measles, diarrhea and respiratory diseases, there are very few data available on the relationship between urinary tract infections (UTI) and vitamin A status. Therefore this study was planned to evaluate the efficacy of co-administration of Vit-A in treating Urinary Tract Infections over the standard regular treatment in our tertiary care hospital. Research Question: What is the efficacy of co-administration of vitamin A in treating Urinary Tract Infections? Methods: A six months observational study was conducted at the Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Pondicherry, from January 2025 to June 2025. About hundred urinary tract infection patients attending the General Medicine OPD were included in the study divided into two groups “A” & “B” and group A treated with standard UTI treatment with Vit-A supplementation where as group B treated with only standard UTI treatment and the efficacy of the treatment was compared. Socio-demographic profiles like age & sex, weight, h/o Hypertension and Diabetes, distribution of clinical symptoms and duration of hospital stay etc; were studied. Results: Significant matching was observed between the two groups. And maximum number of study subjects was observed between 21-30 years of age group among both the groups (group A 42% & group B 38%). About maximum 72% of the study subjects were married among both the groups. It was observed that with regard to signs & symptoms cloudy urine and increased frequency was significantly (P<0.05) decreased among group A patients when compared to group B. With reference to other features there was significant (P<0.05) difference observed among group A patients regard to Duration of hospital stay and Average duration of negative urine culture etc.

Background:  CAD remains the number one cause of morbidity and death related deaths within the world and multivessel and left main coronary artery disease (LMCAD) are high risk subtypes of the anatomy. Angioplasty- coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI), are probably the highest points of treating severe coronary artery disease (CAD) though the best methodology remains a thorny subject in the current world of drug-eluting stents (DES). Objectives: The aim of the meta-analysis was to compare the long-term ( five years or more ) survival, major adverse cardiac events (MACE), myocardial infarction (MI) and repeat revascularisation and the secondary outcomes, namely stroke, quality of life (QoL), angina resolution and hospitalization in adults with CAD, using CABG and PCI. Methods:  Systematic searching of PubMed/MEDLINE, Embase, Cochrane Library, Web of Science and Scopus databases was performed (January 2000 to May 2024) and grey literature and hand-searching of references were sought. They added studies that were randomized controlled trials (RCTs) and high-quality cohort studies of adults with multivessel CAD or LMCAD with 5 years follow-up. An inverse-variance DerSimonianLaird Random-effects model was used to combine Hazard ratios (HR) or relative risks (RR) with 95 confidence interval (CI). The statistic I 2 and Cochran Q test were computed to find out the heterogeneity. Results:  Ten studies (six RCTs, four cohort; total n = 21,546) met inclusion criteria. CABG was associated with improved survival (HR = 0.88, 95% CI: 0.81–0.96), reduced MACE (RR = 0.80, 95% CI: 0.74–0.87), MI (RR = 0.84, 95% CI: 0.73–0.97), and repeat revascularization (RR = 0.43, 95% CI: 0.37–0.50). Stroke risk was slightly higher with CABG (RR = 1.18, 95% CI: 1.02–1.37). Heterogeneity was low to moderate (I² = 25–42%).Conclusion:  CABG has the best long-term outcomes in patients with complex multi-problem CAD and diabetics and results in the greater durable potential albeit a detrimental increment in perioperative stroke risk. PCI is still a possibility in cases of lower complexity and high risk surgeons. The findings support the significance of an individualized and multidisciplinary approach to “heart team” decision-making

Background: Postoperative pain management in cesarean deliveries presents unique challenges, with effective pain relief being essential for patient satisfaction and recovery. The use of Transverse Abdominis Plane (TAP) block has been increasingly favored as a part of multimodal analgesia strategies. This study aims to compare the analgesic efficacy of Bupivacaine alone versus Bupivacaine combined with Dexamethasone in TAP blocks, specifically focusing on the duration of analgesia, pain intensity, and the need for additional analgesic interventions.  Methodology This study was conducted as a randomized controlled trial involving 172 women undergoing elective cesarean sections under spinal anesthesia. Patients were randomly assigned to two groups: Group A Received Bupivacaine and Dexamethasone, while Group B received Bupivacaine in the TAP block. The primary outcome measures included the duration of effective postoperative analgesia, visual analog scale (VAS) pain scores at specified intervals, and the frequency of rescue analgesic requirements. Secondary outcomes included the incidence of postoperative complications and overall patient satisfaction. Results The addition of Dexamethasone to Bupivacaine significantly extended the duration of postoperative analgesia by approximately 7 hours compared to Bupivacaine alone. Group B patients reported lower VAS pain scores at all-time points postoperatively and required fewer rescue analgesics. The combination therapy was also associated with a reduced incidence of opioid-related side effects and enhanced patient comfort. Conclusion The combination of Bupivacaine and Dexamethasone in TAP blocks offers a superior analgesic profile for cesarean deliveries, providing prolonged pain relief and reducing the need for additional analgesics. This approach should be considered a standard component of enhanced recovery protocols in obstetric surgery.

Background: Vitamin D, beyond its classical role in bone and mineral metabolism, has been implicated in glucose homeostasis and insulin sensitivity. Deficiency of vitamin D is highly prevalent in India and may contribute to poor glycaemic control in type 2 diabetes mellitus (T2DM). This study aimed to evaluate the association between serum vitamin D levels and glycaemic as well as lipid parameters in patients with T2DM. Methods: A cross-sectional study was conducted at a tertiary care hospital in eastern India over three months. A total of 150 adult T2DM patients on metformin monotherapy were enrolled, comprising 75 cases with vitamin D deficiency (<20 ng/ml) and 75 controls with sufficient levels (≥20 ng/ml). Groups were matched for age, gender, BMI, and duration of diabetes. Primary outcome was glycated hemoglobin (HbA1c), while secondary outcomes included fasting blood sugar (FBS), postprandial blood sugar (PPBS), and lipid profile (total cholesterol, LDL, HDL, triglycerides). Data were analyzed using unpaired t-test and Fisher’s exact test, with p<0.05 considered significant. Results: Patients with vitamin D deficiency had significantly higher HbA1c (7.29% vs. 6.97%, p=0.0497), FBS (157.89 vs. 145.23 mg/dl, p=0.0048), and PPBS (203.54 vs. 181.49 mg/dl, p<0.0001) compared to controls. Only 36% of deficient patients achieved HbA1c <7.0%, versus 52% in controls. Lipid analysis revealed significantly higher total cholesterol (210.83 vs. 195.07 mg/dl, p=0.0221) and LDL (137.28 vs. 124.56 mg/dl, p=0.0380) in deficient patients, while HDL and triglycerides showed no significant difference. Conclusion: Vitamin D deficiency is significantly associated with poorer glycaemic control and adverse lipid parameters in T2DM patients. Routine screening and correction of vitamin D deficiency may represent a valuable adjunctive strategy in comprehensive diabetes management, particularly in populations with high prevalence of deficiency

Background: Polypharmacy is increasingly prevalent among elderly patients due to multimorbidity, but it carries a heightened risk of drug–drug interactions (DDIs). Age-related physiological changes, including altered pharmacokinetics and pharmacodynamics, further increase susceptibility to adverse outcomes. This study aimed to evaluate the prevalence, nature, and clinical impact of DDIs in hospitalized elderly patients on polypharmacy. Methods: A prospective observational study was conducted over six months in the Department of General Medicine at a tertiary care hospital in eastern India. Patients aged ≥65 years on polypharmacy (≥5 medications) were enrolled. DDIs were identified using Medscape® and Lexicomp® databases and classified as minor, moderate, or major. Clinical outcomes assessed included serious adverse events and duration of hospital stay.  Results: Among 262 patients, 68.32% had minor DDIs, 35.88% moderate DDIs, and 16.41% major DDIs. Major DDIs were significantly associated with older age (mean 74.23 vs. 70.87 years, p=0.0285), dyslipidaemia (60.47% vs. 38.81%, p=0.0111), and neuropsychiatric disorders (37.21% vs. 13.24%, p=0.0006). Patients with major DDIs had a longer mean hospital stay (9.57 vs. 7.03 hours, p<0.0001) and a higher incidence of serious adverse events (16.28% vs. 5.02%, p=0.0154). The risk of major DDIs increased with higher medication counts (>8 drugs). Conclusion: This study demonstrates a high prevalence of clinically significant DDIs among elderly inpatients on polypharmacy, with major DDIs contributing to prolonged hospitalization and increased adverse events. Systematic medication reconciliation, clinical pharmacologist review, and use of interaction screening tools are essential to mitigate risks and improve therapeutic outcomes in this vulnerable population

Background: While glycated hemoglobin (HbA1c) is the established standard for glycemic control, growing evidence suggests that glycemic variability (GV)—the amplitude, frequency, and duration of glucose fluctuations—may be an independent risk factor for diabetic complications. However, long-term data linking GV to the incidence and progression of microvascular complications are limited. Methods: We conducted a prospective cohort study of 352 T2DM patients recruited from a tertiary diabetes center. At baseline and annually for five years, participants underwent 14-day continuous glucose monitoring (CGM) to calculate GV metrics, primarily the Mean Amplitude of Glycemic Excursions (MAGE). Comprehensive assessments for retinopathy, nephropathy, and neuropathy were performed at baseline and at the end of the study. Patients were stratified into tertiles based on their 5-year average MAGE (Low, Moderate, High GV). Cox proportional hazards regression was used to analyze the association between GV tertiles and a composite microvascular outcome. Results: Over a median follow-up of 5.1 years, 102 patients (29.0%) developed the composite microvascular outcome. The incidence was significantly higher in the high GV tertile (45.3%) compared to the moderate (26.5%) and low GV (15.4%) tertiles (p<0.001). The mean 5-year HbA1c was similar across groups (7.4% ± 0.6% vs. 7.6% ± 0.7% vs. 7.7% ± 0.8% for low, moderate, and high GV, respectively; p=0.112). After adjusting for mean HbA1c, age, sex, diabetes duration, and other confounders, the high GV tertile was associated with a significantly increased risk of the composite outcome (Hazard Ratio [HR] 2.92, 95% CI 1.68–5.08, p<0.001) compared to the low GV tertile. Conclusion: Long-term high glycemic variability is a potent and independent predictor of the incidence and progression of microvascular complications in patients with T2DM. These findings suggest that targeting GV, in addition to achieving HbA1c goals, may be a crucial strategy for preventing long-term diabetic complications

Background: Anemia is a common comorbidity in hospitalized patients, associated with increased morbidity and mortality. The two most frequent types are anemia of chronic disease (ACD) and iron deficiency anemia (IDA). Distinguishing between them is crucial for appropriate management, yet their comparative prevalence and impact on clinical outcomes in a general inpatient population remain poorly characterized. Methods: We conducted a retrospective, cross-sectional analysis of adult patients admitted to a tertiary academic medical center. Patients with anemia (hemoglobin <13 g/dL for men, <12 g/dL for women) who had complete iron studies and C-reactive protein (CRP) levels were included. Patients were categorized into ACD (ferritin >100 ng/mL, transferrin saturation [TSAT] <20%, CRP >5 mg/L) or IDA (ferritin <30 ng/mL, or ferritin 30–100 ng/mL with TSAT <20%). Independent t-tests and chi-square tests were used for statistical comparisons. Results: Of 482 eligible anemic patients, 221 (45.8%) were classified as having ACD and 145 (30.1%) as having IDA. The remaining patients had mixed or other anemia types. Patients with ACD were significantly older (68.4 ± 12.1 vs. 55.2 ± 15.8 years, p<0.001) and had a higher mean Charlson Comorbidity Index (4.8 ± 1.9 vs. 2.5 ± 1.5, p<0.001). Compared to the IDA group, the ACD group experienced a significantly longer mean hospital LOS (8.2 ± 4.5 vs. 6.1 ± 3.3 days, p<0.001), a higher 30-day readmission rate (24.9% vs. 15.2%, p=0.028), and greater in-hospital mortality (8.1% vs. 3.4%, p=0.045). Conclusion: In this hospitalized cohort, ACD was more prevalent than IDA and was associated with significantly poorer clinical outcomes, including longer hospitalizations, higher readmission rates, and increased mortality. These findings suggest that ACD is not merely a benign laboratory finding but a marker of severe underlying disease, highlighting the importance of its accurate diagnosis and the management of the associated inflammatory condition

Introduction: Among female genital tract related malignancies, ovarian tumors are the leading cause of mortality. The present study was conducted to identify the various histopathological spectrums of ovarian neoplasm according to the World Health Organization (WHO) classification in a single center. Objective: To assess the histological patterns of ovarian neoplasm their clinical presentation and age distribution. Methods: It is a retrospective study conducted over a period (Nov 2022-Oct 2024) at Government General Hospital, Kakinada. A total of 200 cases were followed and ovarian specimens are obtained after excluding functional cyst. Data was analysed and tabulated. Results: Out of 200 cases of ovarian tumors, 88.5% cases were benign, 7% cases were borderline, 4.5% cases were malignant. Conclusion: Most of the ovarian tumors benign tumors followed by borderline and then malignant. In this study most common benign tumor is serous cystadenoma.  From this study by histopathology, we can differentiate benign from malignant

COVID-19 has shown significant variability in its clinical presentation and severity, often influenced by underlying comorbidities and metabolic derangements. This study investigates the relationship between COVID-19 severity, renal failure, and glycemic variations in hospitalized patients. Retrospective analysis of 150 COVID-19 patients revealed that the presence of DKA and renal failure was strongly associated with increased ICU admissions and mortality. Glycemic variations, particularly hyperglycemia during the acute phase, were significant predictors of worse outcomes. CKD patients demonstrated heightened vulnerability to severe disease, likely due to impaired immune responses and metabolic imbalances. These findings emphasize the importance of early recognition and management of these conditions in mitigating adverse outcomes in COVID-19 patients.

Chronic alcohol consumption is associated with significant alterations in hematological parameters, including red blood cell (RBC) indices, white blood cell (WBC) counts, platelet levels, and biochemical markers, which may serve as early indicators of systemic effects and aid in the diagnosis and management of alcohol-related disorders. This systematic review, conducted following PRISMA guidelines, analyzed studies published between 2019 and 2025 that investigated hematological changes in individuals with chronic alcohol use. Databases including PubMed, Scopus, and Web of Science were searched for observational, cross-sectional, or cohort studies reporting on RBC indices, WBC counts, platelet levels, or biochemical markers in alcohol users. A total of 22 studies met the inclusion criteria, consistently demonstrating that chronic alcohol intake leads to macrocytic anemia, evidenced by elevated mean corpuscular volume (MCV) and reduced hemoglobin and RBC counts. Leukopenia and thrombocytopenia were also prevalent, indicating compromised immune function and increased bleeding risk. Furthermore, biochemical markers such as MCV, gamma-glutamyl transferase (GGT), and carbohydrate-deficient transferrin (CDT) were elevated, reflecting liver dysfunction and excessive alcohol intake, while alcohol withdrawal syndrome was associated with fluctuations in hematological and inflammatory markers. These findings highlight that chronic alcohol use profoundly impacts hematological and biochemical profiles, underscoring the importance of routine hematological screening in individuals with alcohol use disorders to enable early detection and timely intervention.

Background: Post-stroke seizures are a notable complication of cerebrovascular events, particularly in elderly patients, with significant impact on prognosis and quality of life. This study aims to analyze the characteristics and patterns of post-stroke seizures, examining associations with demographic factors, lesion characteristics, stroke classification, and stroke severity. Aim: To assess the demographic and clinical characteristics of post-stroke seizures, examining associations with stroke subtypes, lesion location, seizure types, and stroke severity as per NIHSS and Oxfordshire classifications. Material and Methods: This prospective, cross-sectional study was conducted at the Neurology Department, St. Stephen’s Hospital, Delhi, over a period of 19 months. Sixty patients presenting with a first episode of post-stroke seizure were included. Inclusion criteria were based on clinical findings, neuroimaging (MRI or CT), and EEG. Data were analyzed using descriptive statistics, and correlations were assessed using Chi-square tests. Results: Among the study cohort, 62% were male, with a mean age of 65.8 years; 81% were over 50 years. Focal seizures were more common (56.6%) than generalized seizures (38.4%), with immediate onset seizures occurring in 55% of cases. Cortical lesions were more associated with seizures (65%) than subcortical lesions (11.6%), particularly in the left hemisphere (55%). PACI was the most common ischemic stroke type (64%) associated with seizures, while larger volume ICH presented greater risk in hemorrhagic stroke. Significant associations were found between NIHSS severity and stroke subtype (p = 0.0001), as well as with Oxfordshire classification (p = 0.00001). Conclusion: Post-stroke seizures exhibit distinct demographic and clinical patterns, with focal seizures predominating in cortical and left-sided lesions. PACI and cardio-embolic strokes were linked to higher seizure risk. Stroke severity as measured by NIHSS and Oxfordshire classification were significantly associated with seizure onset, underscoring the importance of targeted monitoring in high-risk groups.

Background: Lung cancer has emerged as the leading cause of cancer-related mortality globally. Various clinical, socioeconomic, and environmental factors have been implicated in its development. However, such comprehensive studies are limited in developing countries, hindering the formulation and execution of effective public health policies. Aim: To assess the clinic-epidemiological and pathological characteristics of lung cancer patients presenting to a tertiary care teaching hospital in South India. Methods: A total of 160 patients with histologically confirmed bronchogenic carcinoma were included in this study. Cases with other malignancies or isolated malignant pleural effusion without clear evidence of bronchogenic carcinoma were excluded. Results: The findings reveal a troubling pattern of delayed diagnosis, presentation at advanced stages, and poor survival rates among bronchogenic carcinoma cases. Conclusion: Implementing robust strategies for early detection and prompt intervention could significantly improve outcomes for lung cancer patients in this region. Enhancing awareness and streamlining referral pathways in primary care may play a vital role in improving survival rates in this population.

Background: Isolated lower limb monoparesis is a rare clinical presentation of stroke, often mistaken for peripheral or spinal pathology. Infarcts in the anterior cerebral artery (ACA) territory, particularly involving the paracentral lobule, can present with contralateral lower limb weakness. Non contrast CT scan of brain which is usually the first investigation for suspected acute strokes could detect the ACS infarct in only 25%. 20 % of patients present with only isolated lower limb weakness and a normal NCCT brain in these cases may lead to erroneous localization of pathology to a peripheral cause. [1] Case Summary: We report three cases of patients presenting with isolated lower limb monoparesis due to ACA territory infarcts.  Two patients underwent MRI brain with diffusion-weighted imaging (DWI) and one patient underwent urgent NCCT head, which was able to demonstrate the cerebral infarct. Lesions were localized to the medial frontal cortex, specifically the paracentral lobule. Timely imaging led to appropriate diagnosis and management with favorable outcomes. Conclusion: Central causes should be considered in patients presenting with lower limb monoparesis. ACA infarcts, though uncommon, are a critical differential diagnosis and can be accurately identified with neuroimaging.

We report the case of a 56-year-old female diabetic and hypertensive with ovarian carcinoma undergoing staging laparotomy. She presented with chemotherapy-induced neutropenia, complicated by rhino-orbital mucormycosis, cavernous sinus thrombosis and lower limb ischemia (Raynaud’s phenomenon). Perioperative considerations included management of vasospastic disorder and balancing the anticoagulant therapy and pain management. This case highlights the multidisciplinary challenges in anaesthetic management of complex, immunocompromised patients with invasive fungal infections and vascular comorbidities.

Introduction: Fever and pain are among the most common complaints in pediatric practice, resulting in numerous outpatient and emergency visits each year. Symptomatic management of these conditions improves children’s comfort, reduces parental anxiety, and prevents unnecessary healthcare utilization. Acetaminophen has traditionally been the most frequently used antipyretic and analgesic in children due to its safety, availability, and cost-effectiveness. However, it has a short half-life and lacks anti-inflammatory properties. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), offers combined antipyretic, analgesic, and anti-inflammatory effects, with a longer duration of action. Naproxen, another NSAID, provides sustained pain and inflammation control but is less commonly studied for routine pediatric fever management. While comparative trials exist for acetaminophen versus ibuprofen, few studies have evaluated naproxen alongside these two drugs. This study aimed to compare the efficacy and safety of acetaminophen, ibuprofen, and naproxen in children presenting with fever and associated pain. Materials and Methods: A prospective, randomized, open-label, parallel-group  trial was conducted in children aged 6 months to 12 years with fever (>38°C) and mild-to-moderate pain. A total of 210 children were randomized into three groups of 70 each: Group A received acetaminophen 15 mg/kg every 6 hours, Group B received ibuprofen 10 mg/kg every 6–8 hours, and Group C received naproxen 5 mg/kg every 12 hours. Baseline demographic data, clinical history, body temperature, and pain scores were recorded. Body temperature was measured hourly for the first 6 hours and then at 12 and 24 hours. Pain was assessed at baseline, 1, 4, 8, and 24 hours using the FLACC scale for younger children and the Wong-Baker Faces Pain Rating Scale for older children. The primary outcome was the mean reduction in body temperature at 4 hours post-drug administration. Secondary outcomes included pain score reduction, duration of fever relief, and adverse effects. Data were analysed using ANOVA and Chi-square tests, with p < 0.05 considered statistically significant. Results: The mean age of participants was similar across groups (acetaminophen 5.9 ± 2.8 years, ibuprofen 6.1 ± 2.6 years, naproxen 6.0 ± 2.9 years; p = 0.82), and gender distribution was comparable (p = 0.91). Baseline fever and associated symptoms were evenly distributed among groups. At 1 hour, mean temperature reduction was 0.6 ± 0.2°C for acetaminophen, 0.8 ± 0.2°C for ibuprofen, and 0.7 ± 0.2°C for naproxen (p = 0.09). At 4 hours, ibuprofen showed a significantly greater temperature reduction (1.6 ± 0.3°C) compared to acetaminophen (1.2 ± 0.3°C) and naproxen (1.5 ± 0.3°C) (p = 0.001). Pain scores decreased more rapidly with ibuprofen (1.8 ± 0.5 at 1 hour, 3.1 ± 0.8 at 4 hours) than with acetaminophen (1.4 ± 0.6 at 1 hour, 2.5 ± 0.7 at 4 hours) and naproxen (1.7 ± 0.6 at 1 hour, 3.0 ± 0.7 at 4 hours), with significant differences at 1, 4, and 8 hours (p < 0.05). Adverse effects were mild and comparable, although naproxen showed a slightly higher incidence of gastrointestinal discomfort. Conclusion: Ibuprofen provides more rapid relief of fever and pain in children compared to acetaminophen and naproxen, particularly within the first 8 hours of treatment. After 24 hours, all three drugs are similarly effective. Naproxen is effective but may cause more stomach-related side effects. Ibuprofen is recommended as the first-line choice for fast symptom relief, acetaminophen remains a safe alternative, and naproxen may be reserved for situations requiring longer dosing intervals with caution in younger children.

Introduction: Patients of Chronic Urticaria (CU) face significant issues due to bothersome itching and hives, and their condition often doesn’t respond well to treatments. Chronic idiopathic urticaria (CIU) can be triggered by various factors, with autoimmune issues being one of the most common causes. There’s a crucial need for therapies that not only extend remission periods but also target the key factors contributing to the disease’s development. Aim: To evaluate the effectiveness of histaglobulin, a combination of histamine and human immunoglobulin, in providing symptom relief for Chronic Urticaria (CU) patients, and to assess the differential impact in ASST-positive and ASST-negative groups. Materials And Methods: This was a single-center, open-label, non-randomized, prospective clinical study involving       CU patients. Participants received a weekly 1 mL subcutaneous injection of histaglobulin for eight weeks. They were also allowed to take cetirizine 10 mg tablets as needed, without exceeding the recommended dose. The drug's efficacy was evaluated using the Urticaria Activity Score (UAS 7), a simple, validated scoring system. Assessments were conducted at each weekly visit, with a final evaluation after 24 weeks. Results: Twenty-eight chronic urticaria patients completed an 8-week course of histaglobulin treatment. The average age was 38.2 years, with a male-to-female ratio of 1.3:1, and an average disease duration of 18.2 months. The baseline Urticaria Activity Score (UAS) significantly decreased from 19.6 to 3.9 following treatment (p < 0.0001) and remained low at 3.5 after 24 weeks, indicating sustained improvement. Most patients (89%) achieved complete remission by week 24, with the majority experiencing excellent or good responses to therapy. Conclusion: Histaglobulin significantly improves symptoms and achieves high remission rates in chronic urticaria patients. Its safety and tolerability make it an excellent adjunct treatment option.

Background: Soft tissue tumors of the extremities comprise a heterogeneous group of benign and malignant lesions with variable clinical behavior. Accurate preoperative diagnosis is critical for management. Fine-needle aspiration cytology (FNAC) offers a rapid, cost-effective, and minimally invasive diagnostic option, but its accuracy requires validation against histopathology. Objective: To assess the diagnostic accuracy of FNAC in soft tissue tumors of extremities and correlate cytological findings with histopathological diagnoses. Methods: A prospective study was conducted at Bombay Health Care, Ujjain, from May 2024 to April 2025. A total of 120 patients with clinically suspected soft tissue tumors of extremities underwent FNAC followed by histopathological examination. FNAC results were categorized as benign, malignant, or suspicious. Diagnostic indices including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated using histopathology as the gold standard. Results: Out of 120 cases, FNAC classified 72 (60%) as benign, 40 (33.3%) as malignant, and 8 (6.7%) as suspicious. Histopathology confirmed 70 benign and 50 malignant tumors. FNAC showed 45 true positives, 5 false negatives, 68 true negatives, and 2 false positives. The calculated sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 90%, 97.1%, 95.7%, 93.1%, and 94.2% respectively. Lipoma was the most common benign tumor (42.8%), while pleomorphic sarcoma was the most frequent malignant tumor (32%). Conclusion: FNAC is a simple, safe, and highly accurate technique for evaluating soft tissue tumors of extremities. It serves as an effective first-line investigation to guide management decisions. However, histopathology remains indispensable for definitive diagnosis, grading, and subtyping.

Background: Meditation and mindfulness-based interventions (MBIs) are increasingly recognized for their potential effects on physiological and psychological health, particularly in regulating cardiovascular parameters and stress responses. However, variations in study designs and outcomes necessitate a comprehensive synthesis to evaluate the overall impact of these interventions. Material and Methods: A systematic review was conducted following PRISMA 2020 guidelines. Databases and registers were searched to identify studies evaluating meditation or mindfulness-based interventions on cardiovascular and emotional outcomes. Records were screened for eligibility, with duplicates removed. Data were extracted regarding study design, intervention type, sample size, outcome measures, and results. Quality and risk of bias were assessed using standardized tools. Results: A total of 460 records were identified, with 410 screened after duplicates removal. Of these, 135 full-text articles were assessed for eligibility, and 23 studies were included in the qualitative synthesis and analyses. Findings indicate that slow-paced breathing, meditation, and MBIs are associated with significant reductions in heart rate, blood pressure, and perceived stress levels. Heterogeneity across studies was noted due to differences in intervention duration, participant characteristics, and outcome measures. Overall, evidence quality ranged from moderate to high, with most studies demonstrating consistent physiological and psychological benefits. Conclusion: Meditation and mindfulness-based interventions demonstrate beneficial effects on cardiovascular and emotional health. Despite some heterogeneity, current evidence supports their integration into stress management and cardiovascular wellness programs. Future research should focus on standardized protocols and long-term follow-up to strengthen evidence.