BLDE University Journal of Health Sciences

Gallstone diseases, mainly cholelithiasis and choledocholithiasis, are common surgical conditions influenced by a variety of metabolic and hormonal factors. Recent research suggests a potential link between hypothyroidism and the pathogenesis of gallstones.

To assess the correlation of hypothyroidism in patients diagnosed with cholelithiasis or choledocholithiasis by measuring the biochemical parameters and to determine the clinical significance of hypothyroidism as a potential risk factor in gallstone formation.

This was a cross-sectional study conducted in the Department of Surgery at a medical college in Northern Karnataka between April 2023 and January 2025. A total of 110 patients diagnosed with gallstone disease of all age groups and both genders were included. Patients with known thyroid disorders under treatment or who underwent thyroid surgery were excluded. All patients underwent thorough evaluation. In addition, thyroid function tests (serum T3, T4 and thyroid stimulating hormone (TSH) levels) were performed. These patients underwent the necessary treatment according to standards.

Among the 110 patients studied, 65 (59%) were women and 45 (41%) were men. Middle-aged patients were predominant. Hypothyroidism was detected in 15 patients (13.6%), of whom 11 were women, while the remaining 95 patients (86.4%) were euthyroid.

Subclinical hypothyroidism may be a potential contributing factor in the development of gallstone diseases. Routine screening for thyroid dysfunction in patients diagnosed with cholelithiasis or choledocholithiasis is recommended. Early identification and management of hypothyroidism may reduce the recurrence or progression of gallstone disease.

Metabolic syndrome (MetS) includes risk factors such as obesity, dyslipidemia, hypertension, and insulin resistance. Psychiatric patients are at higher risk due to medication effects and lifestyle factors. Despite its serious consequences, MetS is often underdiagnosed in this group. This study was conducted to study the prevalence of MetS in psychiatric patients attending the tertiary care center in southern India.

This analytical cross-sectional study includes 179 patients with a previously diagnosed psychiatric condition. Institutional ethical clearance was obtained. Informed consent was obtained from the participants or family members. Baseline demographic details, clinical data, including physical measurements, and laboratory data were collected. Data collected was analyzed with Statistical Package for Social Sciences (SPSS) version 24.

In the present study, 59% of the study participants had MetS. The proportion of MetS among them increased with age (P < .001) and duration of psychiatric illness (P = .001). Patients with lower educational qualifications had higher chances of MetS (P < .018). Co-morbidities such as type 2 diabetes mellitus (DM) and hypertension were noted to be significantly associated with MetS (P < .001). There was a statistically significant association between alcohol consumption (P = .044) though there was no statistically significant association with smoking (P = .51). There was no statistically significant difference between the major psychiatric diagnosis such as bipolar affective disorder, depression, psychoses and the development of MetS (P = .86). Majority of the patients were non-compliant to their medications and none of the specific categories of drugs used had any significant statistical association with the MetS.

We observed a higher burden of MetS among psychiatric patients and identified factors that directly or indirectly would have contributed to its development. Addressing these factors is essential to prevent long-term complications associated with MetS.

The leading cause of death in developing nations is poisoning, which is a significant health care issue. In India, where the majority of people are connected to agriculture and industrial farming, acute pesticide poisoning is extremely common. Early diagnosis and treatment are the most important modes for preventing mortality. However, the only way to address this issue is through prevention.

To describe clinical and epidemiological characteristics observed in individuals with organophosphorus (OP) poisoning at a tertiary health care center.

A cross-sectional study was carried out during the study period (October-November 2022) in a tertiary health care facility. Institutional Ethics Committee (IEC) clearance was obtained. Clinico-epidemiological features of patients presenting to tertiary care centers were evaluated using a pre-validated questionnaire. A descriptive study was conducted, and the data depict the clinical and epidemiological features of the study sample.

A total of 39 subjects presented to the emergency room with clinical signs of OP poisoning during the study period. The preliminary data showed that 77% of the patients were young and had easy access to poison at home, and it was mostly suicidal (84.61%) in intention. They were admitted to a tertiary care facility and treated accordingly.

Clinical and epidemiological characteristics depend on the type, quantity of poison consumed, and type of exposure. So, the treating health care professionals should have appropriate knowledge toward the treatment of op poisoning as, time matters the most in saving lives.

Enterococci have emerged as the common cause of serious nosocomial urinary tract infections.

To isolate and identify uropathogenic Enterococci and to study the antibiogram, vancomycin-resistant Enterococci (VRE), and high-level aminoglycoside resistance (HLAR).

The urine specimens (3448) were cultured on CLED and MacConkey’s agar. Enterococcal isolates were identified and subjected to antibiotic sensitivity testing (minimum inhibitory concentration) by the Vitek 2 automated method. Statistical analysis was done using the Graph Pad InStat Software.

Among the 3448 urine samples, Enterococci were responsible for 148 cases of urinary tract infections (UTIs) (4.29%). Enterococcus faecalis (69.6%) was the most common followed by E. faecium (19.6%). Enterococci were isolated from urine samples with various predisposing (45.95%) factors. Vancomycin resistance (28.38%) and HLAR (52.03%) were the common phenomena. The Enterococci have acquired resistance to erythromycin, tetracycline, and vancomycin. E. faecium was more resistant to most of the antibiotics, including vancomycin and HLAR, than E. faecalis. The emergence of linezolid resistance (27.7%) was noted in our study.

VRE, HLAR, and multidrug resistance were significantly observed more among patients with prolonged hospitalization, catheterization, and hypertension. Enterococcal UTI is an emerging infection in India. Wiser use of antimicrobial drugs is possibly guided by novel techniques for rapid microbiological diagnosis.

Snakebite envenomation remains a significant public health issue in India, with a continuous need for comprehensive data on its epidemiology, clinical manifestations, and treatment outcomes. This study aims to analyze the demographic, clinical, and epidemiological profiles of snakebite victims and evaluate their clinical outcomes.

This retrospective observational study was conducted over 1 year (January–December 2024) at a 2500-bed tertiary care hospital in Mangaluru. Using a chart review method, data were collected from medical records of patients admitted with snakebite history. The study analyzed demographic details, clinical signs and symptoms, treatment protocols, and laboratory findings.

A total of 183 snakebite cases were documented. There was a clear link between the type of treatment provided and patient outcomes, including discharge status, complications, and mortality. Key factors influencing outcomes included co-existing health conditions, delay in hospital presentation, severity of local and systemic envenomation, and the species of snake involved. Patients with delayed access to care often presented with significant laboratory abnormalities, reflecting severe envenomation.

The study underscores the ongoing threat of snakebite in India and the critical need for prompt medical care. Delays in treatment were associated with worse clinical and laboratory outcomes. These findings highlight the importance of rapid response systems, early intervention, and adherence to treatment protocols, and they offer valuable guidance for improving public health strategies and clinical management of snakebite cases.

Interoception, the sensing of internal physiological states, is fundamental to homeostasis but remains underrepresented within core physiology teaching and clinical reasoning.

To highlight interoception as an integrated physiological system and synthesize its neural, humoral and cortical mechanisms across organ systems.

This conceptual communication reviews established experimental and clinical literature on visceral afferent pathways, gut–brain hormones, cortical integration and organ-specific internal sensing to propose an integrative physiological framework.

Interoception arises from coordinated signalling through vagal and spinal afferents, circulating hormones and central processing within the insula and anterior cingulate cortex. Cardiovascular, gastrointestinal, urinary, nociceptive and immune systems generate continuous internal feedback that supports autonomic regulation, behavioural adaptation and subjective awareness. Disruptions in interoceptive processing are implicated in anxiety disorders, chronic pain, fatigue and functional syndromes.

Recognizing interoception as a formal physiological domain may enhance integrative teaching and improve clinical interpretation of symptoms lacking structural correlates, thereby bridging objective regulation with subjective experience.

Uterine rupture in an unscarred uterus is a rare but life-threatening obstetric emergency associated with high maternal morbidity and mortality.

Mid-20s multiparous woman (P3L3) developed uterine rupture and concomitant bladder injury following an instrumental full-term vaginal delivery. The patient presented with hypovolemic shock, with severe anemia, frank hematuria, and ultrasonographic evidence of a broad ligament hematoma. Emergency laparotomy revealed extensive uterine rupture extending from the cornua to the cervix, a 3 cm posterior bladder wall tear, and massive hemoperitoneum. Peripartum hysterectomy, bladder repair, and left internal iliac artery ligation were performed. Despite aggressive resuscitation, she developed disseminated intravascular coagulation, acute kidney injury, and refractory hypotension, culminating in cardiac arrest and death 48 hours after admission.

This case highlights the critical importance of early recognition, timely surgical intervention, and multidisciplinary management to prevent maternal mortality in high-risk deliveries.