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Parth J Rana,1 Himanshu Deshmukh,2 Urmil Shah,3 Vinod Kumar,4 Sanghamitra Kanungo,5 Deepika Singhal,6 Santosh Kumar Mahapatra,7 Ira Vakharia,8 Mukesh Jaiswal,9 Ajitkumar Gondane,10 Pooja Vaidya,10 Vinayaka Shahavi,9 Harish Shandilya,11 Dattatray Pawar,10 Akhilesh Sharma12 1Department of Retina and Trauma Surgery, Netralaya Superspeciallity Hospital, Ahmedabad, Gujarat, India; 2Department of Retina; ‘Daulat’ Deshmukh Eye Hospital, Khaparde Gardens, Amravati, Maharashtra, India; 3Department of Retina, P.N. Desai Eye Hospital, Ahmedabad, Gujarat, 380052, India; 4Department of Ophthalmology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India; 5Department of Retina, Kar Vision Eye Hospital, Bhubaneswar, Odisha, 751007, India; 6Department of Ophthalmology, GMERS Medical College and Civil Hospital, Ahmedabad, Gujarat, India; 7Department of Retina, JPM Rotary Club of Cuttack Eye Hospital and Research Institute, Cuttak, Odisha, 753014, India; 8Department of Retina, Nirmal Hospital Pvt Ltd, Surat, Gujarat, 395002, India; 9Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, India; 10Medical Affairs Department, Alkem Laboratories Ltd., Lower parel, Mumbai, India; 11Global Product Development, IPM & Regulatory Affairs, Enzene Biosciences Ltd., Pune, India; 12Medical Affairs and Clinical Research Department, Alkem Laboratories Ltd., Lower Parel, Mumbai, IndiaCorrespondence: Ajitkumar Gondane, Medical Affairs, ALKEM Laboratories Ltd., ALKEM HOUSE, “Devashish”, Adjacent to Matulya Centre, Senapati Bapat Marg, Lower Parel, Mumbai, 400 013, India, Tel +8983375722, Email ajitkumar.gondane@alkem.comObjective: This study aimed to compare efficacy, safety, and immunogenicity of the biosimilar ranibizumab in comparison with the Innovator Ranibizumab in treatment-naive patients with neovascular (wet) age-related macular degeneration (nAMD or wAMD).Materials and Methods: This comparative, double blind, multicentre, Phase III clinical study randomized eligible patients in a 3:1 ratio to receive either OPTIMAB® (Alkem Laboratories Ltd./ Enzene Biosciences Ltd.) or Innovator Ranibizumab. Intravitreal injections of Innovator Ranibizumab (0.5 mg in 0.05 mL) and OPTIMAB® (0.5 mg in 0.05 mL) were administered every four weeks for 12 weeks (three doses). Primary efficacy endpoints included loss of < 15 letters from baseline, gain of ≥ 15 letters from baseline in visual acuity, mean change in best corrected visual acuity (BCVA) from baseline, and change in central subfoveal thickness (CSFT) from baseline at week 12. Safety was assessed through monitoring of adverse events (AEs) and serious adverse events (SAEs) throughout the study.Results: Overall, of the 152 patients randomized, 141 (92.8%) patients (mean age, 66.6 ± 9.37 years) completed the study. Percentage of patients who lost < 15 letters in BCVA at week 12 from baseline was comparable in both the groups (100.0%, each). On secondary end point analysis, the two groups had comparable mean changes in BCVA (OPTIMAB®, 11.8 ± 9.18; innovator ranibizumab, 12.9 ± 10.29; P = 0.5509); proportion of patients who gained ≥ 15 letters in visual acuity (OPTIMAB®, 32.18%; innovator ranibizumab, 25.74%; P = 0.4785) and mean change in CSFT (OPTIMAB®, − 76.6 ± 89.03; Innovator ranibizumab, − 73.1 ± 92.23 μm; P = 0.8422) at week 12 as compared to baseline. OPTIMAB® and innovator ranibizumab demonstrated comparable safety over the 12-week treatment period and no patient expressed anti-ranibizumab antibody in either group patient.Conclusion: Biosimilar ranibizumab (OPTIMAB®) was non-inferior to innovator ranibizumab in terms of efficacy, safety, and immunogenicity in the patients of nAMD.Keywords: biosimilar ranibizumab, best corrected visual acuity, central subfoveal thickness, nAMD

Siddhartha Dutta,1 Rima B Shah,1 Shubha Singhal,1 Sudeshna Banerjee Dutta,2 Sumit Bansal,3 Susmita Sinha,4 Mainul Haque5 1Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Gujarat, India; 2Department of Medical Surgical Nursing, Shri Anand Institute of Nursing, Rajkot, Gujarat, India; 3Department of Anesthesiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India; 4Department of Physiology, Khulna City Medical College and Hospital, Khulna, Bangladesh; 5Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, MalaysiaCorrespondence: Mainul Haque, Email runurono@gmail.com

Rui Xue,1,&ast; Haiting Xiao,2,&ast; Vinod Kumar,3 Xiqian Lan,2 Ashwani Malhotra,4 Pravin C Singhal,4 Jianning Chen1 1Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, People’s Republic of China; 2Key Laboratory of Luzhou City for Aging Medicine, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China; 3Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India; 4Feinstein Institute for Medical Research and Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, 11030, USA&ast;These authors contributed equally to this workCorrespondence: Jianning Chen; Pravin C Singhal, Email chenjn1987@zju.edu.cn; psinghal@northwell.eduAbstract: Diabetic nephropathy (DN) is a common complication affecting many diabetic patients, leading to end-stage renal disease. However, its pathogenesis still needs to be fully understood to enhance the effectiveness of treatment methods. Traditional theories are predominantly centered on glomerular injuries and need more explicit explanations of recent clinical observations suggesting that renal tubules equally contribute to renal function and that tubular lesions are early features of DN, even occurring before glomerular lesions. Although the conventional view is that DN is not an inflammatory disease, recent studies indicate that systemic and local inflammation, including tubulointerstitial inflammation, contributes to the development of DN. In patients with DN, intrinsic tubulointerstitial cells produce many proinflammatory factors, leading to medullary inflammatory cell infiltration and activation of inflammatory cells in the interstitial region. Therefore, understanding the molecular mechanism of renal tubulointerstitial inflammation contributing to DN injury is of great significance and will help further identify key factors regulating renal tubulointerstitial inflammation in the high glucose environment. This will aid in developing new targets for DN diagnosis and treatment and expanding new DN treatment methods.Keywords: diabetic nephropathy, renal tubules, renal tubular injury, renal tubulointerstitial inflammation, DN injury

Background: Amblyopia is the leading cause of monocular visual acuity impairment that often arises in early childhood with every 2 to 10 children in 100 being affected. Prevention of amblyopia is most effective during early childhood, as interventions become increasingly challenging once the condition progresses and the individual matures. The Lazy-Eye-Scope aims to prevent ocular morbidity in toddlers by early detection of amblyopia. Objective: To develop the The Lazy-Eye-Scope a low cost, technology enabled screening tool that aims to provide easy and affordable amblyopia detection. Methodology: An equipment will be developed to convert normal light into polarized light. It will include a plastic body containing polarising filters and a light source. This light source is directed on the eye through the refracting lens. This introduces a portable device that is extremely scalable, which will be designed for community level use. Conclusion: Thi s device is expect4ed to provide useful insight for the differently abled population including down syndrome and autism. This innovative screening tool holds promise in mitigating ocular morbidity and improving visual outcomes for toddlers worldwide. The simple methodology and usage of the device enables easy use by everyone even if they are not technically skilled.

Background: The incorporation of medical humanities, an interdisciplinary field of medicine, in medical education may offer significant benefits to the medical community. This study was done to assess the attitude of medical students regarding empathy towards patients and to find out the perception of students about the inclusion of humanity studies to their undergraduate medical curriculum. Methodology: It was a Cross-sectional study done among Final Year MBBS Part One and Part Two, Post Graduate Students of Clinical Specialities and Interns of Kasturba Medical College, Mangalore and its associated teaching hospitals. Data was collected using semi-structured questionnaire which consisted of three sections including Participant information, Jefferson Scale of Physician Empathy – Student’s Version (JSPE-S) which will be used to measure empathy towards patients among medical students and questions on assessing the perception of students regarding the introduction of humanity studies in the medical curriculum. The collected data were entered and analyzed using SPSS version 11.5. Likert scale was analysed using median (±2SD). For qualitative data statistical test Chi-square was used Results: The mean age of the 410 students who were surveyed was 22.11 with a standard deviation of ± 2.136. 41% of the respondents were male and 59% were female. The Jefferson Scale of Physician Empathy is measured on a scale of 20-140. Among the participants, 167 (40.7%) students scored between 46-90, categorized according to the Jefferson Scale as moderately empathetic. 243 students scored between 91-140 - categorized as high empathetic. None of the students scored between 20-45 (least empathetic category) Conclusion: Our study found that all the respondents were either moderately or highly empathetic according to the Jefferson Scale of Physician Empathy. A majority of respondents felt that it is important to understand the feelings and body language of the patient and that the emotions of the patient and family are important in the physician-patient relationship.

Introduction: The preferred management of medial meniscus tears has notably moved from meniscectomies towards repair. With a higher volume of meniscal repairs being done all across the world with every passing day, the lack of an objective and definitive sign suggesting the adequacy of its repair is daunting. The purpose of our study was to introduce a unique and novel arthroscopic sign formed after adequate repair of the medial meniscus, the AMR (Adequacy of Medial meniscus Repair) sign. We hypothesised that it is not only the objective end point for repair, but can also form the indicator for excellent clinical, functional, and radiological outcome even in the long term. Materials and methods: This was a multicentric, prospective study initiated by the corresponding author, and the findings validated subsequently by the other authors. Overall, it included 804 patients of isolated medial meniscus tear operated with arthroscopic all-inside technique between January 2014 and December 2017. Patients were segregated into three groups based on whether an S-shaped curve in the free, inner edge of the medial meniscus sign was formed post-repair, lost after further tightening, or not formed upon subjective completion of repair. All the patients were followed-up and evaluated based of medial joint line tenderness, McMurray’s test for medial meniscus, IKDC score, WOMET score, and radiologically using an MRI at the terminal follow-up. Results: The mean terminal follow-up was 42.34±4.54 months. There was significant (p

Siddhartha Dutta,1 Rima B Shah,1 Shubha Singhal,1 Sudeshna Banerjee Dutta,2 Sumit Bansal,3 Susmita Sinha,4 Mainul Haque5 1Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Gujarat, India; 2Department of Medical Surgical Nursing, Shri Anand Institute of Nursing, Rajkot, Gujarat, 360005, India; 3Department of Anaesthesiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India; 4Department of Physiology, Khulna City Medical College and Hospital, Khulna, Bangladesh; 5Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, MalaysiaCorrespondence: Shubha Singhal, Department of Pharmacology, All India Institute of Medical Sciences-Rajkot, Ayush Block, Khanderi, Para Pipaliya, Rajkot, Gujarat, India, Tel +91 9560372056, Email Drshubhasinghal@gmail.com Mainul Haque, Unit of Pharmacology, Faculty of Medicine and Defence Health Sciences, Universiti Pertahanan Nasional Malaysia, National Defence University of Malaysia- Kem, Perdana, Sungai Besi, Kuala Lumpur, 57000, Malaysia, Tel +60 109265543, Email runurono@gmail.comAbstract: Metformin has been designated as one of the most crucial first-line therapeutic agents in the management of type 2 diabetes mellitus. Primarily being an antihyperglycemic agent, metformin also has a plethora of pleiotropic effects on various systems and processes. It acts majorly by activating AMPK (Adenosine Monophosphate-Activated Protein Kinase) in the cells and reducing glucose output from the liver. It also decreases advanced glycation end products and reactive oxygen species production in the endothelium apart from regulating the glucose and lipid metabolism in the cardiomyocytes, hence minimizing the cardiovascular risks. Its anticancer, antiproliferative and apoptosis-inducing effects on malignant cells might prove instrumental in the malignancy of organs like the breast, kidney, brain, ovary, lung, and endometrium. Preclinical studies have also shown some evidence of metformin’s neuroprotective role in Parkinson’s disease, Alzheimer’s disease, multiple sclerosis and Huntington’s disease. Metformin exerts its pleiotropic effects through varied pathways of intracellular signalling and exact mechanism in the majority of them remains yet to be clearly defined. This article has extensively reviewed the therapeutic benefits of metformin and the details of its mechanism for a molecule of boon in various conditions like diabetes, prediabetes, obesity, polycystic ovarian disease, metabolic derangement in HIV, various cancers and aging.Keywords: metformin, diabetes, pleotropic effect, cancer, cardiovascular, neuroprotection, Prediabetes

Kirti Singhal, Surekha Chukkali Department of Psychology, CHRIST (Deemed to be University), Ghaziabad, Delhi NCR, IndiaCorrespondence: Surekha Chukkali, Department of Psychology, CHRIST (Deemed to be University), Mariam Nagar, Meerut Road, Ghaziabad, Delhi NCR, 201003, India, Tel +91 9901775477, Email surekha.chukkali@christuniversity.inAbstract: The spread of the novel coronavirus has led to a rise in morally conflicting situations for healthcare professionals. Doctors and nurses who were serving as frontline workers, require special attention to alleviate the long-lasting impact of the potentially morally injurious events. The current study aims to validate the Moral Injury Symptom Scale-Healthcare Professionals (MISS- HP) among Indian healthcare workers. The 10-item MISS was administered to 150 doctors and 150 nurses using the purposive sampling method. Firstly, reliability was assessed using internal consistency measure. Secondly, item discrimination index was assessed by calculating the point biserial correlation for each item. Cronbach alpha indicated high internal consistency (0.77). The point biserial correlation value for each item indicated good discrimination. Finally, confirmatory factor analysis (CFA) was performed to replicate the factor structure. CFA results suggested a good fit to the data. In conclusion, MISS-HP is a reliable and valid tool to assess moral injury among Indian healthcare professionals in India.Keywords: pandemic, moral conflict, moral dilemma, frontline workers

Background: Interprofessional Education (IPE) has gained recognition in health professions education due to evolving healthcare roles and systems, emphasizing collaboration for quality care. Attitudinal barriers hinder its implementation, necessitating a deeper understanding of student perspectives. This study explores the attitudes of medical (MBBS), dental (BDS), and allied health science (AHS) students towards interprofessional learning (IPL) in a cross-sectional study at Kasturba Medical College (KMC) and Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore. Methodology: A total of 205 students participated, comprising 150 MBBS, 40 BDS, and 15 AHS students. Data was collected through a modified semi-structured questionnaire, assessing attitudes towards IPL using Likert scales. Statistical analysis was conducted using SPSS ver. 20.0, with results expressed in medians and significance determined by the Mann-Whitney test. Results: Overall, students demonstrated positive attitudes towards IPL, with significant agreement that it enhances communication skills, facilitates professional relationships, and improves clinical problem-solving. Both MBBS and non-medical students expressed willingness to learn with peers from diverse healthcare disciplines, indicating a shared understanding of the importance of collaborative practice. Conclusion: The study highlights favourable attitudes among medical, dental, and allied health science students towards interprofessional learning, suggesting a readiness for collaboration in healthcare practice. These findings underscore the importance of incorporating interprofessional education opportunities within healthcare curricula to foster teamwork and enhance patient care outcomes.

Background: Hypertension (HTN) poses a substantial health challenge globally, affecting nearly one billion people. Due to its silent nature, early detection is crucial to prevent end-organ damage. Recent studies suggest a correlation between hypertension and upper body subcutaneous fat accumulation, particularly in the neck circumference (NC). This anthropometric measure is proposed as practical surrogate for assessing visceral obesity, surpassing traditional measures like waist circumference. Objectives: To correlate Neck Circumference (NC) with blood pressure in adults and to correlate other risk factors of HTN with NC. Methodology: This Case Control Study was conducted at Government Wenlock Hospital, KMC Attavar, and KMC outreach clinics. The study population included hypertensive cases and non-hypertensive controls, with a sample size of 110 in each group. Participants above 25 years of age were included, and those with specific conditions were excluded. Mercury Sphygmomanometer, Stethoscope, Flexible measuring tape, and Weighing scale were used as study instruments. Results: Overall, 79.5% of individuals with NC > median consumed a non- vegetarian diet, and those with high salt intake were 1.42 times more likely to develop HTN. Although not statistically significant, 53% of those with a high cholesterol diet had NC greater than median. The study emphasizes the need for larger sample sizes for more conclusive results. Conclusion: The study establishes a positive correlation between blood pressure and NC, proposing NC as a practical and socially acceptable anthropometric marker. The non-invasive nature and simplicity of NC measurement make it a feasible tool for routine assessment, potentially impacting hypertension guidelines.

Deepak Saxena,1,2,&ast; Poonam Trivedi,1,&ast; Priya Bhavsar,1,&ast; Farjana Memon,1 Abhi Thaker,1 Chintan Chaudhary,1 Sandul Yasobant,1,2,&ast; Deepika Singhal,3 Sanjay Zodpey4 1Department of Public Health Science, Indian Institute of Public Health Gandhinagar (IIPHG), Gandhinagar, India; 2School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, India; 3Department of Ophthalmology, Gujarat Medical Education & Research Society, Ahmedabad, India; 4Public Health Foundation of India (PHFI), Gurgaon, India&ast;These authors contributed equally to this workCorrespondence: Deepak Saxena, Indian Institute of Public Health Gandhinagar (IIPHG), Opp. Air Force Head Quarters, Nr. Lekawada, Gandhinagar, Gujarat, 382042, India, Email ddeepak72@iiphg.orgPurpose: Despite the global efforts to improve organ donation, there is a demand-supply gap for organs in India. The only solution to meet this disparity is to improve deceased donor transplants in the country through victims of road accidents. The government has instituted several initiatives to achieve this goal. However, challenges and barriers continue to affect the organ donation process. The present study aims to document the motivating factors and obstacles in the decision of families to donate organs in Ahmedabad, Gujarat and their suggestions to improve the processes involved in organ donation.Patients and Methods: A qualitative exploratory study (in-depth interview) of ten relatives of deceased organ donors was conducted from Oct 2021 to Feb 2022. Interviews were audio recorded, and detailed notes were taken during the interview. Thematic analysis was done using ATLAS.ti version 8 software.Results: The significant motivators identified were family members’ belief or conviction that it would help save the lives of others; a sense of moral obligation to do so as bodies of brain-dead persons can contribute to this noble goal, no use of the body after death, an extension of life, and being a role model for others. The challenges were mistrusting the organ donation process, fear of being responsible for any mishappening, and feeling of shock. The suggestions to improve organ donation included awareness creation, simplifying the legal process for accidental deaths, providing benefits to the donor family, and a system for identifying potential donors and their counselling.Conclusion: The present study reflects the need for a more comprehensive awareness campaign to generate awareness and remove the misconception about organ donation in India. The findings of the study can be helpful for policymakers to amend the current organ donation process in India and improve the disequilibrium of demand and supply of deceased donations in India.Keywords: organ donation, factors, motivators, barriers

The current study examines an essential type of vehicle routing problem (VRP). This type is one where customers are served by limited-capacity vehicles from multiple depots and is known as Multi-Depot Capacitated Vehicle Routing Problem (MDCVRP). The novelty of this study is that in the present case, cars, after Leaving the Depot, can go back to any other depot. Those issues seem to occur in most real-world issues where information, messages, or news are sent electronically from somewhere. The purpose of the problem is to minimize the costs associated with routing. Regarding the literature on such issues, it has been proven in previous studies and research that these problems are among the hard-NP problems, and to solve them using the metaheuristic method, the exact methods justify it. After changing the basic model, this study developed a Tabu Search (TS) algorithm. The study results demonstrate that if the equipment can return to any depot, the cost is significantly reduced in contrast to the case where equipment is forced to return to their depot.

Abstract This is a case series of three patients in our hospital system who developed acquired thrombotic thrombocytopenic purpura (aTTP) after testing positive for COVID‐19 infection. Two patients had acute COVID‐19 infections, and one had COVID‐19 IgG antibodies consistent with prior COVID‐19 infection. Twelve additional cases of aTTP after COVID‐19 infection were found in the literature. COVID‐19 creates alterations in the vWF‐ADAMTS‐13 axis with reduced ADAMTS‐13 in acute illness that may lead those patients who are predisposed into fulminant aTTP. Further genetic studies are necessary to uncover why some patients with COVID‐19 can have concurrent aTTP. For those with a prior COVID‐19 infection, molecular mimicry with autoantibodies to ADAMTS‐13 is likely the predominant trigger, but having an underlying predisposition (prior episode of TTP, genetic predisposition to autoimmune conditions, or breast cancer history) creates an environment that could be a possible trigger for aTTP.

Background: Vaginal dryness is common during and after menopause due to declining oestrogen, vulvovaginal atrophy (VVA), up to about a year after delivery during breast feeding and in many other conditions. This can be distressing to painful for women and may cause discomfort and dyspareunia. This study was performed to evaluate the use and practicability of secretions of male bulbourethral glands (Cowper's glands) to alleviate the discomfort, dyspareunia or pain at sexual activity, because of inadequate lubrication of vagina. Method: When a healthy male is sexually aroused, Cowper's glands produce a mucous-like fluid called pre-ejaculate. This fluid is a clear, colourless, viscous, and salty liquid, which is emitted from the urethra of the penis. A lubrication free wet condom on penis during foreplay can prevent loss of these secretions during an extended foreplay and lubrication around penis due to these secretions can effectively serve as physiological lubricant during coitus. Result: This technique and secretion of Cowper’s glands are a good lubrication for dryness of vagina during coitus. Sexual function assessment revealed a marked improvement in all domains of sexual function to both partners. A physiological secretion being natural to the sexual act and providing motive for extending foreplay; it is arguably the best lubricant for coitus in situations of dry vagina. Conclusion: Supposedly the secretions may also help in reducing dose of HRT for menopause, extended foreplay adds to psychosexual benefits and a boost to sexual hormonal milieu.

Eco-design is a crucial approach in achieving sustainable manufacturing, which seeks to reduce the environmental impact of products and processes throughout their lifecycle. This paper explores the principles and tools that are used in eco-design, providing an overview of the key concepts and methods for sustainable manufacturing. The principles of eco-design are centered on minimizing the environmental impact of products and processes through the use of renewable resources, reducing waste and emissions, and improving energy and material efficiency. The paper discusses these principles in detail and highlights the benefits that can be achieved by implementing eco-design in manufacturing. The tools and methods of eco-design include life cycle assessment (LCA), design for environment (DfE), and environmental management systems (EMS) whereas DfE involves designing products and processes to minimize their environmental impact. EMS provides a framework for managing environmental performance across an organization. The paper also discusses the challenges of implementing eco-design in manufacturing, including the need for collaboration across different functions within an organization, the availability of data and resources, and the complexity of the supply chain. Organizations can implement eco design by utilizing Life Cycle Assessment, eco-labeling, and Design for the Environment. This approach can help organizations initiate or improve sustainable production practices.

Introduction: Headache is one of the most common conditions troubling nearly 68% of the world's population. Tension-type headache (TTH) & migraine are the most common forms of classical headaches, which is nowadays mostly neglected, associated with frequent, severe pain and significant functional impairment. Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. Various studies demonstrated tDCS as a valued device to treat neuropsychiatric conditions such as chronic headache & associated anxiodepressive condition. Objective: The aim of this the current review was to evaluate the effectiveness of tDCS in the management of TTH and Migraine. Results generated from various studies for the effectiveness of tDCS in TTH & Migraine. Methods: We programmed our search strategy, to identify studies pertaining to use of tDCS and pain management in TTH & migraine, within the Database of the Cochrane Library of Systematic Reviews, & various author manuscripts in PMC, MEDLINE, EMBASE, NLM, PsycINFO, Other indexed citations from inception to December 2021 and potentially relevant studies. Outcomes: The outcomes of interest include: Effective pain management, in terms of headache intensity, frequency, its episodes, associated depression, anxiety, in target population prioritised by the individual reviews. The evidences were mapped and synthesised with appropriate health problem, patient subgroups, intervention type, context and outcome.Conclusions: We found a significant reduction of pain intensity in patients receiving tDCS treatment, also the pain intensity and duration were significantly improved from baseline after tDCS treatment and during a follow-up period. There was a significant reduction of pain intensity by both anodal and cathodal stimulation conditions, with noteworthy decrease in episodic headaches equally by both 1mA and 2mA current intensities. The aforementioned works support the utility of tDCS in the pain management of TTH and migraine offering a hope for patients with this debilitating disease. However, the review shows promising results in the pain management by tDCS, but the included studies must be analysed critically since most of them were pilot studies, with some having adapted an open-label design.