Ovarian cancer is among the most fatal gynecologic cancers, posing considerable difficulties with early detection, treatment and overall prognosis. This study aims to assess the correlation between the miR-146a rs2910164 polymorphism and the susceptibility to ovarian cancer in an Iraqi population. A total of 130 individuals were enrolled, categorized into two groups: 60 cases and 70 controls. The CC genotype was the most common, observed in 30 cases (38.5%), which was substantially more than the control group, which included 10 controls (14.3%), resulting in an Odds Ratio (OR) of 6.00 (95% CI: 2.56-14.09, p 0.001). The GG genotype exhibited no statistically significant difference between cases (10 cases, 12.8%) and controls (20 controls, 28.6%), indicating a protective effect. The C allele was notably more prevalent in cases (70 alleles, 44.9%) than in controls (40 alleles, 28.6%), with odds ratios of 3.50 (p<0.001) and 0.29 (P=0.001), respectively. This work contributes to the increasing data indicating that this genetic variation may function as a significant diagnostic biomarker and treatment target.

Diabetic foot infections represent significant complications associated with diabetes mellitus, often complicated by the development of multidrug-resistant pathogens. This study aimed to investigate the molecular characteristics of carbapenem-resistant Escherichia coli isolates recovered from diabetic foot infections through Multi-Locus Sequence Typing (MLST). A total of nine clinical samples were collected from private laboratories in Diwaniya City, Iraq. The VITEK 2 Compact system was utilized for bacterial identification and antimicrobial susceptibility analysis. All isolates demonstrated resistance to multiple antibiotics, including amoxicillin/clavulanic acid, piperacillin/tazobactam, ertapenem and imipenem, various cephalosporins, and trimethoprim/sulfamethoxazole. Three isolates selected for MLST that carried out using seven housekeeping genes, with amplification achieved via PCR followed by sequencing. Sequence typing showed that the isolates were categorized into diverse sequence types: ST34, ST218, and ST10. These findings indicate that carbapenem-resistant E. coli strains causing diabetic foot infections in Diwaniya are genetically diverse. Further studies employing comprehensive molecular typing methods are warranted to better understand the epidemiology and transmission dynamics of these resistant strains.

This study investigates the effects of Nerium oleander oil on sex hormones (testosterone, estrogen and progesterone) in male and female albino rats. In addition to evaluating serum levels of thyroid hormones (T3, T4 and TSH) Using a controlled laboratory setup. Forty adult male and female albino rats were divided into control (G1) and treatment groups (G2, G3, G4). treatment groups were treated with different concentrations of oleander oil (50 mg/kg, 100 mg/kg and 200 mg/kg) respectively. Hormonal analysis was conducted using ELISA kits to determine serum levels after administration of Nerium oil for 30 days. The results revealed significant alterations in hormone levels in treated rats compared to controls, indicating a potential hormonal modulatory effect of the oil. Males’ Significant reduction in testosterone levels observed in treated groups, especially at high doses (100 and 200) mg/kg by (0.83±0.06 and 0.53±0.03) ng/mL respectively. In the same way, estradiol and progesterone have reduced in the high doses till reach (0.30±0.02 pg/mL and 0.17±0.03) respectively at p<0.05. In female, a mild but statistically insignificant decrease in estrogen and progesterone levels compared to control. Group 3 exhibited a significant decrease (p<0.05) in both hormones. In the aspect of thyroid gland in male rats, it is found that T3 (ng/dL) gradually decreases through G2 and G3 to the lowest in G4 (0.883±0.015) in comparsion to the highest in G1 (1.627±0.025) at statistically significant differences between all groups (LSD = 0.0392). T4 (µg/dL) follows a similar trend, highest in G1 (6.300±0.000), lowest in G4 (3.400±0.200). TSH (µIU/mL) fall in Opposite trend: Lowest in G1 (0.650±0.010) and increases to highest in G4 (1.233±0.015). In females, T3 (ng/dL) has highest in G1 (1.45±0.015), progressively decreasing through G2 and G3, with the lowest in G4 (0.79±0.010). T4 (µg/dL) decreases from G1 (5.63±0.058) to G4 (3.13±0.152), showing a clear downward trend. TSH (µIU/mL) shows an inverse trend compared to T3 and T4: lowest in G1 (0.713±0.015), increasing to highest in G4 (1.410±0.01). There's a progressive decline in T3 and T4 and a rise in TSH from G1 to G4. This suggests a worsening of thyroid function, with G4 potentially indicating a hypothyroid state. These findings suggest caution in the medicinal use of Nerium oleander, especially regarding reproductive and thyroid glands health.

We report the successful anaesthetic management of a 62-year-old female with a bimalleolar fracture and chronic left upper lobe collapse due to sequelae of pulmonary tuberculosis. The surgery was performed at Zonal Hospital, Dharamshala—a peripheral healthcare facility without intensive care unit (ICU) support. A combined spinal-epidural (CSE) anaesthetic technique was used to avoid the risks associated with general anaesthesia in a patient with severely compromised pulmonary reserve. This case underscores the importance of careful preoperative optimization and vigilant perioperative care in managing high-risk patients in resource-limited settings [1,2].

Liposuction is a well-known cosmetic surgical technique performed by plastic surgeons to achieve ideal body contouring by removing excess adipose tissue. Despite being considered a safe procedure, liposuction may result in complications, particularly in patients with comorbidities such as cardiovascular or pulmonary diseases, a history of smoking, or when combined with other surgical procedures. We present a case of a 36-year-old female (BMI 26 kg/m²) who underwent Power-Assisted Liposuction (PAL) (MicroAire) without the use of an energy-based device, followed by a tummy tuck. Postoperatively, the patient developed skin necrosis, which was managed conservatively with Lovenox, calcium channel blocker cream, and later mechanical dermabrasion with tranexamic acid injection. The necrotic area resolved completely within several weeks, and the patient recovered well. This case raises awareness that PAL (MicroAire) can be aggressive and may lead to necrosis, contrary to manufacturer claims of safety.

Background: Diabetic retinopathy, a leading cause of vision loss in India, is a growing concern in Shimla, Himachal Pradesh, where limited eye care access and low awareness hinder preventive screening. This study aimed to evaluate public awareness of diabetic eye disease and the necessity of regular eye check-ups, focusing on addressing knowledge gaps and barriers in Shimla’s urban-rural interface. Materials and Methods: A descriptive, cross-sectional online survey was conducted from January to February 2025, targeting adults aged 18–60 years in Shimla. A bilingual (Hindi/English) questionnaire, hosted on Google Forms, assessed socio-demographic factors, knowledge of diabetic retinopathy, eye check-up practices, and barriers. Using convenience sampling, 420 participants completed the survey. Data were analyzed with IBM SPSS Statistics v27.0, with knowledge scores categorized as Very Good (≥80%), Good (60–79%), Fair (40–59%), and Poor (<40%). Results: Participants, primarily aged 18–35 years (72.8%) and female (55.2%), showed moderate awareness: 80.0% recognized early retinopathy detection via screenings, 83.3% identified intervention benefits, and 85.0% noted fear of diagnosis as a barrier. Gaps existed in annual eye exam frequency (60.0%), asymptomatic disease (63.8%), and management prevention (61.7%). Knowledge levels were Very Good (27.6%), Good (46.2%), Fair (20.0%), and Poor (6.2%). Limited eye care access (32.4%) highlighted rural challenges. Conclusion: While awareness of diabetic eye disease is improving, knowledge gaps and access barriers persist in Shimla. Targeted education, integrated screenings, and rural outreach are crucial to preventing vision loss.

Background: Hand hygiene is a critical public health measure that significantly reduces the spread of infections such as diarrhea, influenza, and COVID-19. In India, socio-cultural practices and regional disparities influence hygiene behavior. This study evaluates awareness and practices related to handwashing in both rural and urban areas of Himachal Pradesh, highlighting socio-demographic influences and identifying barriers to effective hygiene habits. Materials and Methods: A descriptive, cross-sectional online survey was conducted between January and March 2025 among 420 adults in Himachal Pradesh. A structured bilingual questionnaire assessed socio-demographic details, hand hygiene knowledge, behavioral practices, and perceptions. Responses were analyzed using SPSS Version 26, and cumulative knowledge scores were categorized as Very Good, Good, Fair, or Poor. Results: Participants were predominantly young adults (40.5% aged 18–25) with a slight female majority (55.5%) and nearly equal rural-urban representation. Awareness of basic hand hygiene principles was high—87.6% knew its disease-preventive purpose, 84.3% recognized key moments for handwashing, and 77.6% understood the recommended 20-second duration. However, misconceptions about sanitizer use and water temperature persisted. Overall, 76.7% of participants fell into the Good or Very Good knowledge categories, while 5.5% demonstrated Poor awareness, highlighting scope for further intervention. Conclusion: While general awareness about hand hygiene in Himachal Pradesh is encouraging, knowledge inconsistencies and barriers—particularly in rural and less educated populations—persist. Community-driven hygiene education, practical demonstrations, and improved access to water and soap can help close these gaps and promote lifelong healthy hygiene behaviors across the state..

Background: Menstruation is a natural biological process, yet it remains clouded by stigma, myths and misinformation, especially in rural regions like Himachal Pradesh. Poor menstrual hygiene practices and cultural taboos negatively impact adolescent girls’ health, education and self-esteem. This study aimed to assess awareness, attitudes and practices related to menstrual hygiene among adolescent girls and to examine the role of cultural beliefs and accessibility of menstrual health education. Materials and Methods: A descriptive, cross-sectional online survey was conducted between January and March 2025 among 420 adolescent girls aged 13–19 years in Himachal Pradesh. Participants were recruited through convenience sampling across digital platforms. Data were collected using a structured bilingual questionnaire covering menstrual knowledge, attitudes and access to resources. Responses were analyzed using IBM SPSS version 26.0 and knowledge was categorized into Very Good, Good, Fair and Poor levels. Results: Among participants, 36.2% were aged 13–15 years and 59.0% resided in rural areas. While 80.5% understood menstruation’s biological basis and 84.0% recognized the importance of hygiene, only 61.4% and 59.5% were aware of menstrual cups and tampons, respectively. Cultural myths persisted, with about one-fourth believing in food and activity restrictions during menstruation. Knowledge classification showed 29.8% with Very Good, 44.3% with Good, 19.5% with Fair and 6.4% with Poor awareness. Conclusion: Despite encouraging awareness levels, gaps in understanding of modern menstrual products and lingering cultural taboos highlight the need for sustained, targeted menstrual health education. Strengthening school-based programs and community outreach is vital to empowering adolescent girls with the knowledge and confidence to manage menstruation safely and with dignity.

Acute appendicitis remains a significant clinical challenge due to its variable presentations and potential complications. This article reviews the clinical features of acute appendicitis, the importance of accurate diagnosis and the role of clinical scoring systems and imaging modalities in enhancing diagnostic accuracy.

Background: Tennis elbow, or lateral epicondylitis, is a degenerative tendinopathy of the extensor carpi radialis brevis tendon. Traditional management options such as corticosteroid injections provide temporary relief but are associated with recurrence and tendon degeneration. Platelet-rich plasma (PRP) therapy has emerged as a regenerative alternative aiming to promote tendon healing. Objective: To elaborate on the clinical evidence supporting PRP therapy in tennis elbow, compare its efficacy with corticosteroid injections, and highlight recent advancements in PRP preparation and administration. Material and Methods: An evidence-based review was conducted through a synthesis of recent randomized controlled trials, systematic reviews, and meta-analyses evaluating PRP therapy for lateral epicondylitis. Results: PRP therapy demonstrated superior long-term outcomes compared to corticosteroids, including sustained pain relief and improved functional scores. Emerging techniques such as leukocyte-poor PRP formulations and combined scaffold-assisted PRP injections further enhance therapeutic outcomes. Ultrasound-guided injections optimize PRP delivery to affected tendinous regions. Conclusion: Platelet-rich plasma injection is an effective and promising treatment for chronic tennis elbow, offering regenerative healing and durable clinical benefits. Ongoing innovations are expected to refine its role further in musculoskeletal regenerative medicine.

Background: Generic medicines, being pharmaceutically equivalent to branded drugs in terms of safety, dosage, efficacy, and quality, offer a cost-effective alternative to branded medications. Despite governmental promotion through schemes like Jan Aushadhi, public skepticism persists, particularly in rural and semi-urban areas, due to misconceptions about their safety and effectiveness. This study investigates the level of awareness, perceptions, and preferences related to generic medicines among residents of Mandi district, Himachal Pradesh. Materials and Methods: A descriptive, cross-sectional study was conducted between January and March 2025 using a structured online questionnaire. A total of 400 adult residents from both rural and urban areas of Mandi participated. The questionnaire, administered in Hindi and English via Google Forms, captured data on demographics, awareness, perceptions, and usage behavior regarding generic versus branded medicines. Descriptive statistics and categorical analysis were performed using SPSS v26.0. Results: The majority of respondents (40.5%) were aged 26–35 years, with 66.5% from rural areas and 35.8% educated up to secondary school. Awareness about generics was relatively strong: 77.3% correctly identified generic drugs, 87.8% recognized them as more affordable, and 74% agreed they are as effective as branded medicines. However, only 65.8% expressed full trust in generics, and just 59.5% reported that doctors commonly recommend them. A total of 31.8% scored “Very Good” on knowledge and perception, while 27% fell into “Fair” or “Poor” categories, mainly among less educated and lower-income groups. Conclusion: While the findings indicate growing awareness of generic medicines in Mandi, significant trust and knowledge gaps remain particularly concerning safety, regulation, and physician advocacy. To foster wider acceptance, culturally tailored education, stronger provider engagement, and clearer regulatory communication are essential. Bridging these gaps will enhance the uptake of generics and advance equitable access to affordable healthcare.

Background: Generic medicines, being pharmaceutically equivalent to branded drugs in terms of safety, dosage, efficacy, and quality, offer a cost-effective alternative to branded medications. Despite governmental promotion through schemes like Jan Aushadhi, public skepticism persists, particularly in rural and semi-urban areas, due to misconceptions about their safety and effectiveness. This study investigates the level of awareness, perceptions, and preferences related to generic medicines among residents of Mandi district, Himachal Pradesh. Materials and Methods: A descriptive, cross-sectional study was conducted between January and March 2025 using a structured online questionnaire. A total of 400 adult residents from both rural and urban areas of Mandi participated. The questionnaire, administered in Hindi and English via Google Forms, captured data on demographics, awareness, perceptions, and usage behavior regarding generic versus branded medicines. Descriptive statistics and categorical analysis were performed using SPSS v26.0. Results: The majority of respondents (40.5%) were aged 26–35 years, with 66.5% from rural areas and 35.8% educated up to secondary school. Awareness about generics was relatively strong: 77.3% correctly identified generic drugs, 87.8% recognized them as more affordable, and 74% agreed they are as effective as branded medicines. However, only 65.8% expressed full trust in generics, and just 59.5% reported that doctors commonly recommend them. A total of 31.8% scored “Very Good” on knowledge and perception, while 27% fell into “Fair” or “Poor” categories, mainly among less educated and lower-income groups. Conclusion: While the findings indicate growing awareness of generic medicines in Mandi, significant trust and knowledge gaps remain particularly concerning safety, regulation, and physician advocacy. To foster wider acceptance, culturally tailored education, stronger provider engagement, and clearer regulatory communication are essential. Bridging these gaps will enhance the uptake of generics and advance equitable access to affordable healthcare.

Background: Osteoarthritis (OA) stands among the leading causes of chronic disability in older adults, yet awareness regarding its early signs and lifestyle-based management remains insufficient in many low-resource settings. Particularly in rural and semi-urban populations, this knowledge gap contributes to delays in diagnosis and increased functional decline. This study evaluates awareness, misconceptions, and early management practices related to OA among elderly individuals in Kangra district, Himachal Pradesh. Materials and Methods: A community-based descriptive cross-sectional study was conducted from January to March 2025 involving 410 participants aged 60 years and above. A validated questionnaire was used to assess socio-demographic variables, OA-related knowledge, and health behaviors. Scores were categorized as Very Good (≥80%), Good (60–79%), Fair (41–59%), and Poor (<40%). Statistical associations were tested using chi-square analysis. Results: Of the 410 participants, 71.2% demonstrated good to very good knowledge. While 83.6% accurately identified OA as a joint degenerative disorder, only 52.1% recognized exercise as a key non-pharmacological intervention. Beliefs that OA is an inevitable part of aging or only treatable through surgery were noted in a significant fraction. Lower educational attainment and rural residence were strongly associated with limited awareness. Conclusion: The findings emphasize moderate awareness with notable misconceptions, especially concerning early management and non-surgical options. Bridging this gap through targeted geriatric education, accessible physiotherapy programs, and culturally relevant outreach can reduce disability and promote healthy aging. Regular screening and community-led joint care initiatives must be integrated into rural public health programs for long-term impact.

Background: Glaucoma, known as the "silent thief of sight," is a major cause of irreversible blindness worldwide. Due to its asymptomatic progression, early detection relies heavily on public awareness. In Himachal Pradesh, challenging geography, limited eye-care infrastructure and prevalent misconceptions impede timely diagnosis and management, highlighting the need for targeted assessments of community awareness. Material and Methods: A descriptive cross-sectional study was conducted among 400 adult participants across Himachal Pradesh between October and December 2024. Data were collected through a structured, validated questionnaire evaluating socio-demographic characteristics, glaucoma awareness and healthcare-seeking behaviors. Participants were recruited using convenience and purposive sampling via digital platforms (WhatsApp, Facebook). Statistical analysis involved descriptive statistics and chi-square tests  using  SPSS  v26,  adhering  to  ethical  research  protocols. Results: Participants primarily belonged to the 26-35 years age group (34.8%), had balanced gender representation (50.5% females) and predominantly resided in rural areas (56.8%). General glaucoma knowledge was adequate, with 78.5% correctly identifying optic nerve damage as a key feature. However, significant misconceptions existed regarding the asymptomatic nature of glaucoma (69.5% awareness), anatomical involvement (65.5% correctly identified optic nerve damage) and preventive nutritional factors (64.0% aware of Vitamin E benefits). Overall, 77.5% exhibited "Good" or "Very Good" knowledge, while 22.5% had "Fair" or  "Poor"  understanding,  particularly  among  rural,  older  and less-educated groups. Conclusion: Residents of Himachal Pradesh demonstrated satisfactory basic awareness about glaucoma, yet crucial knowledge gaps persist, especially regarding its asymptomatic nature, preventive measures and risk factors. Addressing these gaps through targeted, culturally appropriate education, enhanced rural healthcare access and routine ophthalmic screenings is essential for reducing glaucoma-related blindness in the region. 

Background: Anesthesia has transformed modern medicine by enabling painless surgical and diagnostic procedures. However, public understanding of its types, safety, and administration remains clouded by myths and misconceptions-especially in semi-urban and rural regions like Shimla. Misinformation can lead to unnecessary fear, poor compliance, and hesitancy to consent, thereby affecting perioperative outcomes. Materials and Methods: A descriptive, cross-sectional study was conducted among 400 adults in Shimla between October and December 2024. Participants were selected using purposive and convenience sampling across both urban and rural settings. A structured, pre-tested questionnaire in Hindi and English assessed socio-demographics, knowledge of anesthesia, and prevailing misconceptions. Each correct response earned one point, with scores categorized into Very Good (>80%), Good (60-79%), Fair (41-59%), and Poor (<40%). Data were analyzed using SPSS v26.0. Results: Out of 400 respondents, the majority were aged 26-35 years (34.8%), with 52% female and 55.3% from rural areas. While 78.5% correctly identified anesthesiologists as the primary providers of anesthesia and 76.8% knew patients do not feel pain under general anesthesia, several myths persisted-such as anesthesia being instantly reversible (66.5%) or always requiring a breathing tube (68.3%). Overall, 38.3% demonstrated Very Good knowledge, 41.3% Good, 15.5% Fair, and 5.0% Poor knowledge. The findings revealed substantial awareness alongside notable gaps in understanding more nuanced aspects of anesthesia. Conclusion: Public awareness in Shimla regarding anesthesia is encouraging, but significant misconceptions remain-particularly concerning safety, effects, and procedural details. Targeted educational efforts, improved provider-patient communication, and community-based awareness initiatives are essential to bridge these gaps and promote informed, confident decision-making around anesthesia.

Avian Paramyxoviruses (APMVs) pose a significant threat to both wild and domestic bird populations, with severe implications for the poultry industry. This study focuses on the detection and characterization of APMVs in domestic birds in Mosul city, Iraq. The Hemagglutination (HA) and Hemagglutination Inhibition test (HI), a serological assay used to detect and quantify antibodies against APMVs, was employed alongside egg inoculation and serum neutralization tests to identify and characterize local APMV-1 strains. An investigation was conducted across four regions in Mosul to analyze the patterns and prevalence of APMV-1 infections. A local isolate of Avian Paramyxovirus was successfully isolated using the embryonated chicken egg inoculation technique. The isolate was identified and characterized using serum neutralization and HI tests, with a titer of 105.2 EID50/0.1ml determined by embryo titration. In Region 1, 12 samples (21.82% of the total) tested positive, with 4 samples (33.33%) positive by serum neutralization and 8 samples (66.67%) positive by HI. In Region 2, 17 samples were positive, with 8 (32%) by serum neutralization and 9 (68%) by HI. Region 3 showed a balanced distribution, with 16 positive samples (29.09% of the total), equally divided between the two tests. Region 4 had 10 positive samples (18.18% of the total), with 4 (40%) positive by serum neutralization and 6 (60%) by HI. Overall, out of 55 samples, 24 (43.64%) tested positive by serum neutralization, and 31 (56.36%) tested positive by HI. The findings reveal a significant prevalence of APMVs-1 in domestic birds in Mosul, underscoring the need for continuous surveillance and effective control measures to mitigate the spread of the virus. This study highlights the importance of monitoring APMV infections to protect poultry health and the economy. Future research should focus on understanding the transmission dynamics of APMVs and developing targeted vaccination strategies to reduce their impact.
 

Despite extensive efforts to manage infections, bacterial resistance continues to pose a serious concern and rank among the world's leading causes of mortality. Seven new Pyridyl-functionalized 1,2,3-triazoles connected to carbazole components were created using the Cu(I)-catalyzed alkyne-azide cycloaddition CuAAC of substituted-pyridyl azides with a variety of alkyne-functionalized sugars in an attempt to create physiologically active antibacterial drugs. Several spectroscopic methods were used to confirm the novel derivatives' chemical structures. The new clicked 1,2,3-triazoles were tested for in vitro antibacterial activity against two Gram-negative bacterial strains, namely Escherichia coli (MTCC43) and Klebsiella pneumonia (MTCC530), as well as Hay bacillus (MTCC 121) and staph (MTCC96). The results were compared to the activity of the control antibiotic, "Ampicillin." Using the disc assay, compounds (2g, 2f, and 2c) exhibit a considerable zone of inhibition against E. coli and K. pneumonia (24, 22, and 24 mm) and (26, 24, and 21 mm), respectively. Based on the results, it can be said that compound (2g and 2f) has stronger antibacterial activity against B. subtilis and S. aureus than the reference medication.