BackgroundCompassionate support and a nurturing environment are essential for a positive, dignified birthing experience. A dearth of respectful maternity care not only undermines the overall quality of services but also has far-reaching implications on women’s healthcare-seeking behaviour and trust in the health system. Despite increasing institutional deliveries in India, evidence suggests that mistreatment and lack of respectful care persist in healthcare settings. This study assesses the experiences of RMC among postnatal women in a tertiary care hospital in New Delhi and explores its associations with socio-demographic factors.MethodsA hospital-based cross-sectional study was conducted among 300 postnatal women at Lok Nayak Hospital, New Delhi. Participants were selected using a simple random sampling technique. Data were collected using a pre-tested interview which consisted of questions related to their socio-demographic details, obstetric history, domestic or intimate partner violence history and the Person-centered Maternity care (PCMC) scale. Descriptive statistics, chi-square tests, and multivariate logistic regression were used to examine associations between socio-demographic and obstetric factors and RMC scores using Statistical Package for Social Science (SPSS) version 25, and p-value < 0.05 was considered significant.ResultsAll women (100%) reported overall satisfaction with their delivery experience while significant gaps in RMC were observed. Primigravida women were more likely to receive an episiotomy compared to multigravida. Only 33.3% had a birth companion present, despite LaQshya guidelines, and a significant association was found between the presence of a birth companion during the current delivery and the PCMC scores. Multivariate analysis revealed that the presence of a birth companion (AOR = 4.593; 95% CI: 2.393–8.815; p < 0.001) and having a male baby (AOR = 1.718; 95% CI: 1.028–2.87; p = 0.039) were significantly associated with higher RMC scores.ConclusionsThe findings highlight critical gaps in RMC implementation, despite high institutional delivery rates. Strengthening provider training, ensuring birth companionship, and fostering policy enforcement are recommended for improving maternity care quality.Trial registrationThis study was registered in the Clinical Trials Registry - India (CTRI) on 31st July 2023 under the postgraduate thesis as CTRI/2023/07/055918.

Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent chronic liver condition affecting nearly 30% of the global population. Characterized by hepatic steatosis in the absence of significant alcohol intake, NAFLD can progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Although liver biopsy is the diagnostic gold standard, its invasiveness, cost, and associated risks limit widespread application. Artificial intelligence (AI) offers promising non-invasive alternatives by leveraging large datasets to enhance diagnostic precision. To evaluate the diagnostic accuracy of artificialintelligence algorithms for the imaging detection of hepatic steatosis, the essential first step in the metabolic dysfunctionassociated steatotic liver disease (MASLD) spectrum. A comprehensive literature search was conducted across PubMed, Scopus, Embase, Cochrane Library, and Google Scholar for studies published between January 2016 and January 2025. Studies were included if they involved adult populations, employed AI algorithms for NAFLD diagnosis, and reported sufficient diagnostic accuracy measures. Quality assessment was performed using the QUADAS-2 tool. Meta-analysis was conducted using a bivariate random-effects model to estimate pooled sensitivity, specificity, and area under the hierarchical summary receiver operating characteristic (HSROC) curve. Out of 29 studies included in the systematic review, 19 met the criteria for meta-analysis, comprising a total of 344,266 participants. AI-based diagnostic models showed excellent performance, with pooled sensitivity of 91% (95% CI: 84–95%), specificity of 92% (95% CI: 86–96%), and an AUC of 0.97 (95% CI: 0.95–0.98). The diagnostic odds ratio was 123.7, indicating high discriminatory capacity. Convolutional neural networks (CNNs) demonstrated superior accuracy (AUC = 1.00) compared to other AI classifiers. Subgroup analysis revealed higher diagnostic accuracy in studies validated with imaging standards compared to those using liver biopsy. Model performance was also influenced by the type of classifier and validation method used. AI-based models, particularly CNNs, exhibit high diagnostic accuracy for detecting hepatic steatosis and offer promising non-invasive alternatives to traditional modalities. These tools have the potential to transform early detection and screening, especially in resource-limited settings. Future research should focus on external validation, multicentric trials, and standardized reporting for clinical integration.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-17386-3.

Direct head-to-head evidence of propranolol and amitriptyline for migraine prophylaxis is limited. This clinical trial compared the efficacy, safety, and cost-effectiveness of low-dose propranolol versus amitriptyline for episodic migraine prophylaxis over a 3-month period. This randomized, controlled, open-label, prospective, parallel, single-center trial was conducted at a tertiary care hospital in India. A total of 60 prophylaxis-naïve patients with episodic migraine were randomized 1:1 to receive either low-dose propranolol (80 mg/day) or amitriptyline (10 mg/day). The primary outcome was the improvement in the monthly headache frequency at 3 months from baseline, while the secondary outcomes included improvements from baseline in the proportions of patients achieving a ≥ 50% reduction in monthly headache days, headache severity, headache-induced disability, monthly rescue medication intake, quality of life, and cost-effectiveness (measured by the average cost-effectiveness ratio [ACER] and incremental cost-effectiveness ratio [ICER]). At 3 months, propranolol showed a significantly greater reduction in monthly headache frequency compared with amitriptyline (-3.67 ± 1.47 versus - 2.87 ± 1.36 days, P = 0.03). More patients in the propranolol group (60%) achieved a ≥ 50% reduction in monthly headache days compared with the amitriptyline group (43.33%) (P = 0.02). Propranolol also showed a greater reduction in monthly rescue medication intake (P = 0.01), but differences in headache severity, headache-induced disability, and quality of life were not significant. Both groups experienced mild adverse drug reactions. Cost-effectiveness analysis revealed propranolol had a higher ACER (US $5.44) and ICER (US $0.40/1% reduction) than amitriptyline. In our trial, low-dose propranolol demonstrated superior efficacy to amitriptyline in episodic migraine prophylaxis. Both drugs were well tolerated. Our study suggests that amitriptyline was more cost-effective than propranolol. Clinical Trial Registry-India (Date: 27 October 2020; registration no.: CTRI/2020/01/022972).

Neonatal appendicitis is a rare and often misdiagnosed condition due to its nonspecific clinical presentation, commonly mimicking necrotising enterocolitis or intestinal obstruction. We report a case of a 26-day-old term female neonate who presented with fever, diarrhea, bilious vomiting, and abdominal distension. Imaging suggested small bowel obstruction. During exploratory laparotomy, a perforated appendix with localized adhesions was found, along with a distended cecum and collapsed colon. Appendectomy, ileostomy, and colonic mapping biopsies were performed. Histopathology confirmed appendicitis with the presence of ganglion cells. The child recovered fully and is thriving well at 6-month follow-up. This case highlights the importance of considering appendicitis in the differential diagnosis of neonatal intestinal obstruction to avoid delays in treatment and reduce the perforation and mortality rate.

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in multi-organ involvement, with increasing evidence of neurological manifestations such as encephalopathy, encephalitis, stroke, and Guillain-Barré syndrome. This case series reports nine patients admitted between November 2020 and May 2021 with COVID-19–related encephalitis, primarily presenting with altered sensorium and other neurological symptoms. Clinical, laboratory, and cerebrospinal fluid (CSF) analysis as well as neuroimaging findings were reviewed. The patients, aged 30 to 88 years (mean age, 64 years), presented with fever, cough, shortness of breath, and altered sensorium. Neurological examination revealed abnormalities such as altered muscle tone, upgoing plantars, and neck rigidity. Laboratory results showed elevated levels of D-dimer, lactate dehydrogenase, and interleukin-6, indicating systemic inflammation and hypercoagulability. CSF was acellular with normal protein and glucose levels, and SARS-CoV-2 reverse transcription polymerase chain reaction was negative. Neuroimaging varied, with some patients showing normal computed tomography and others demonstrating mild meningeal enhancement or lacunar infarcts. The patients received supportive care, including oxygen therapy, remdesivir, dexamethasone, and ceftriaxone. Outcomes ranged from complete recovery to death, with those over 60 years of age or with significant comorbidities facing a higher mortality risk. Neurological manifestations, particularly encephalopathy, are common in COVID-19, with potential mechanisms involving systemic inflammation and microvascular damage rather than direct viral invasion of the central nervous system. Early recognition and management are crucial, especially in older patients or those with comorbidities, in order to reduce the risk of severe complications and mortality.

Acinetobacter baumannii (A. baumannii) is an important nosocomial pathogen responsible for a wide range of human infections. The emergence of multidrug resistance (MDR) causes life-threatening nosocomial infections. Also, the formation of biofilm helps it survive on abiotic surfaces and is transferred through healthcare workers, thereby causing nosocomial infections. Hence, we study the current antibiotic resistance patterns and virulence factors in our clinical and colonizing isolates. A total of 92 isolates (44 colonizing and 48 clinical) of A. baumannii were included in the study. Antibiotic susceptibility testing was performed by VITEK 2. Biofilm formation was assessed by the tissue culture plate method. Polymerase chain reaction (PCR) for oxacillinases, MBLs and biofilm-associated genes were performed. Meropenem resistance was found in 42 (87.5%) of the clinical and 44 (97.7%) of the colonizing isolates. A strongly adherent biofilm was produced by 11 (22.91%) of the clinical and 12 (27.27%) of the colonizing isolates. Biofilm-associated genes, ompA, bap and csuE were present in 45 (93.7%), 47 (97.9%) and 44 (91.6%) of the clinical isolates, respectively and in all the colonizing isolates. blaOXA23-like was more prevalent in colonizing than clinical isolates. blaOXA-58-like and blaOXA-24-like were present in very few isolates. The presence of metallo beta-lactamase (MBLs) was observed to be lower than oxacillinases. NDM1 was present in 15.29%, SIM in 27%, GIM in 14.11%, VIM in 32.9%, SPM in 5.8%, and IMP in 1.2% of the meropenem-resistant isolates. Carbapenem resistance (XDR) is increasing in A.baumannii. Biofilm formation is an important virulence factor responsible for its survival in the hospital environment and causes nosocomial infections. Biofilm-producing isolates were also found to be carbapenem-resistant. Strict disinfection procedures are to be followed to prevent its spread in the hospital.