Introduction: Shivering is one of the most common complications during spinal anesthesia , leading to patient discomfort and increased metabolic demand. This is a result of blocked sympathetic activity with effective vasodilatation, leading to loss of thermoregulation. This study aimed to compare the efficacy of prophylactic pethidine and tramadol in preventing shivering in patients undergoing spinal anesthesia. Aims and Objective: To analyze the outcome of prophylactic Tramadol hydrochloride and Pethidine hydrochloride for shivering patients who underwent elective surgery under spinal anaesthesia. Method: This prospective, randomized double blinded study, was conducted in 120 ASA 1 and ASA 2 adult patients of either gender scheduled for elective surgery and spinal anaesthesia. Patients were allocated into 2 groups of 30 each, to receive either pethidine or tramadol in a dose of 0.5mg/kg 10 min before administration of spinal anaesthesia. Intraoperative hemodynamic Parameters, incidence and severity of shivering were recorded and statistically analysed with t-tests, chi-square tests and ANOVAs. Result: The incidence and severity of shivering was significantly lower in pethidine group compared to tramadol group (p<0.001). However, pethidine is associated with mild sedation score and lower incidence of nausea and vomiting compared to tramadol. Conclusion: Prophylactic pethidine is more effective than tramadol in reducing the incidence and severity of shivering with minimal sedation in patients undergoing elective infra umbilical surgery under spinal anesthesia.

Introduction: Exercise, Yoga and Visual reaction time may be associated in a variety of ways, however the connection is not always obvious. The interval between the presentation of a stimulus and the commencement of a response is referred to as reaction time. Aims and Objective: The present study was done to know the effect of Yoga performers and Zumba performers on Visual Reaction Time (VRT) for Yellow Color. Method: In the present study after taking informed consent and ethical clearance, data from 50 Yoga performers and 50 Zumba performers (of age group 20- 40 years) were collected and the visual reaction time for yellow colour was measured while performing Zumba and yoga respectively. Result: Statistical results reveal that there is no significant difference in the mean value of VRT (yellow color) between Yoga and Zumba Performers. Conclusion: Since the difference is not statistically significant, we can clearly conclude that yoga and physical exercises (Zumba) both offer unique benefits for cognition and reaction time in their own ways.

Background: Chronopharmacology is a scientific discipline that examines how biological rhythms influence the effects of pharmacotherapy, which is the study of how drug administration timing impacts its efficacy. De-spite its significance, chronopharmacology is often neglected and not extensively researched within the context of therapy optimization. This study aimed to evaluate doctors’ knowledge, attitudes, and practices (KAP) regard-ing chronopharmacology. Materials & Methods: A cross-sectional, descriptive study was conducted using a questionnaire. A total of 100 participants were enrolled after obtaining their consent and given a structured KAP questionnaire consisting of 20 questions. The data collected were expressed in percentages. Results: Findings revealed that 58% of participants were familiar with the term chronopharmacology. Addition-ally, 53% acknowledged that chronopharmacology pertains to the influence of drugs on biological rhythms, such as circadian rhythms. Moreover, 45% of respondents believed that chronotherapy could affect the pharmacokinetics of drug. Furthermore, 65% indicated that they consistently include correct timing for drug administration in their prescriptions. Conclusion: Although a majority of participants were not aware of the term chronopharmacology, they recognized the connection between the biological clock and various diseases and expressed a desire for patient coun-selling on this topic. It is essential to enhance educational efforts for doctors regarding the principles of chro-nopharmacology.

Prevalence autism spectrum disorders (ASD) has been on rise, but many studies suggest over-diagnosed. Cur-rently, children have more access to electronic media on the daily basis than those of previous generation. Some studies suggest that increases screen time is associated with melanopsin-expressing neurons and decreasing gamma-aminobutyric acid (GABA) neurotransmitter, and thus results aberrant behavior, decreased cognitive, and language development. Early exposure of electronic media in early life (< 2 years old) gives an impact on lan-guage, but it still inconclusive. We made a study aiming at revealing the impact of early exposure of electronic screen on language development and autistic-like behavior. Results showed that children who spent viewing ≤ 3 hours per day had language delay and short attention span, while children who spent viewing ≥ 3 hours per day had language delay, short attention span, and hyperactivity. While we found that more than a half of children (66.6%) had no parents-child interaction during the exposure, speech delayed and short attention had been re-ported in all cases, and hyperactivity was found in 66.6% children.

Introduction: Chronic Liver Disease (CLD) is a global health issue with increasing mortality. Neutrophil-to-Lymphocyte Ratio (NLR), a simple marker derived from routine blood tests, has emerged as a potential predictor of disease severity in Chronic Liver Disease. This study investigates the role of NLR in assessing disease severity and predicting clinical outcomes in CLD patient. Method: This one-year observational study at SRMS IMS, Bareilly, included 140 adult CLD patients admitted to the inpatient department, with chronic liver disease confirmed by ultrasound. Patients with secondary immunodeficiencies, hepatocellular carcinoma, or acute liver failure were excluded. Demographic, clinical, and laboratory data, including NLR from blood counts, were collected. Follow-up assessments monitored patient outcomes. Data analysis was performed using SPSS and MS Excel, with ethical approval from the institutional committee. Result: The mean NLR in the study was 3.53 ± 1.22. A significant difference in NLR was found across CTP classes: Class A (2.14 ± 0.78), Class B (3.45 ± 1.18), and Class C (4.14 ± 1.16) with a p-value of 0.01*. NLR showed positive correlations with albumin (r = 0.171, p = 0.044), bilirubin (r = 0.363, p = 0.001), and CTP score (r = 0.386, p < 0.001). Significant differences in albumin (p = 0.015*), prothrombin time (p = 0.021*), and bilirubin (p = 0.001*) were observed across NLR groups. Conclusion: NLR is a reliable and cost-effective marker for assessing the severity and prognosis of CLD. Its association with liver function parameters and CTP score suggests its potential utility in risk stratification and management of CLD patients. Further studies with larger cohorts are recommended to validate its prognostic value.

Background: ex ratio is defined as the number of females per thousand males. The  objectives were  to  study  the knowledge, attitude and the practice of pregnant women on gender preference, prenatal sex determination and female feticide. Methods: It was a hospital based cross-sectional study.  The present study was undertaken among the 204 newly registered pregnant women attending the hospital in Marh block of Jammu district, Jammu and Kashmir, India. A pre-designed, pre-tested and structured questionnaire was used in the study. The data collection technique was a personnel interview of the study subjects. Results: Out of 500 pregnant women 62% had shown no gender preference, 23% preferred male child and 15% had preferred to have female child. Regarding awareness, 88% and 90% women knew that prenatal sex determination and female feticide are illegal, respectively. Conclusions: Being the civilized citizens, it is our duty to raise voice against the declining sex ratio and killing of girl child. Being a woman it is our primary duty as well as concern to come forward to stop this menace.

Background: Despite a slew of national programs aimed at improving the health of mothers since independence, limited access to and utilization of modern healthcare is among the primary causes of India’s high maternal death rate. Methods: Total 100 pregnant females were studied about knowledge and attitude during antenatal care check-up. The study was cross sectional in design. They were asked questions while attending the outpatient clinic in the hospital. Results: 84.00% respondent were known that pregnant women need to go for their checkup. 44.00 % women have knowledge that 1st prenatal check-up should be done in the starting three months of gestation. Almost half of the women knows 52.00% that high blood pressure can affect the growth of their children. Conclusion: The study concluded that overall pregnant women response in yes regarding knowledge about antenatal care.

Background: The study was conducted to review maternal outcome in pregnancy with diabetes. Methods: Study group used single step 75gm oral glucose tolerance test (OGTT) test recommended by WHO for GDM diagnosis. Results: 45% patients had polyhydramnios and 38% developed preeclampsia. Preterm labor was common in 23% of GDM patients. Conclusions: There was significant fetomaternal morbidity in patients with diabetes mellitus. Early diagnosis and treatment reduce the Maternal outcome.

Background: polycystic ovarian syndrome (PCOS) in the present generation is a very common reproductive disorder and the prevalence is on the rise. In this study we compare the maternal outcome in normal and women with PCOS. Methods: This study was a case-control study on pregnant women with h/o PCOS from 5-28 weeks of pregnancy. Results: 9.49% women developed GDM in cases as compared to 1.61% women in control group. The difference in the incidence of GDM in the two groups was statistically significant. When hypertensive disorders of pregnancy were considered, a statistically significant difference was observed as 11.2% cases and 2.42% controls showed HDP. Conclusion: With a detailed comparative analysis of this case-control study, it can be concluded that many antenatal complications are per se increased in women with a history of PCOS.

Background: Infertility affects a substantial percentage of couples globally, with complex cases often involving uterine, ovarian, or unexplained factors that remain challenging to diagnose accurately. Although non-invasive imaging methods such as ultrasound and hysterosalpingography (HSG) are widely used, their limitations in sensitivity and specificity underscore the need for diagnostic laparoscopy, a minimally invasive procedure with high diagnostic accuracy. This study aims to evaluate the utility of diagnostic laparoscopy in assessing complex infertility cases, specifically focusing on uterine, ovarian, and unexplained factors. Methods: A cross-sectional study was conducted on 50 women presenting with either primary or secondary infertility. Each participant underwent diagnostic laparoscopy following standard clinical assessments, including ultrasonography and hormonal profiling. Data were collected on uterine anomalies, ovarian cysts, PCOD, and unexplained infertility cases, and were analyzed to compare findings between primary and secondary infertility groups. Results: Uterine abnormalities, primarily fibroids, were identified in 12% of cases, mainly among primary infertility patients. Ovarian factors, including PCOD and ovarian cysts, were detected in 20% of cases across both primary and secondary infertility groups. Additionally, 12% of cases were classified as unexplained infertility due to the absence of identifiable abnormalities. Diagnostic laparoscopy provided higher detection rates for these factors compared to conventional imaging techniques, underscoring its role in cases where non-invasive methods were inconclusive. Conclusion: Diagnostic laparoscopy is a valuable tool for identifying complex infertility factors, offering a reliable and safe method for comprehensive infertility evaluation. Its high diagnostic accuracy, particularly for detecting uterine, ovarian, and unexplained infertility factors, supports its use as a routine investigative procedure in infertility workups. Recommendations: Laparoscopy should be considered for routine use in infertility evaluations, especially for patients with complex or unexplained infertility, to improve diagnosis and guide targeted treatment.

Background: Premenstrual Syndrome (PMS) affects a significant number of menstruating women, including medical students who face unique stressors. The autonomic nervous system (ANS) is often disrupted in PMS, contributing to various symptoms. Yoga, particularly yogic asanas, may offer a non-pharmacological intervention to improve autonomic function and alleviate PMS symptoms. Objective: To evaluate the effect of yogic asanas on autonomic function tests and PMS symptoms in medical students. Methods: A randomized controlled trial was conducted with 60 medical students diagnosed with PMS, randomly assigned to an intervention group (yoga) or a control group. The yoga intervention included 60-minute sessions three times a week for 8 weeks. Autonomic function was assessed using heart rate variability (HRV) and blood pressure variability (BPV). PMS symptoms and quality of life were measured using the Premenstrual Symptoms Screening Tool (PSST) and WHOQOL-BREF scale. Results: The intervention group showed significant improvements in HRV (SDNN and RMSSD), reductions in BPV, and a notable decrease in PMS symptom severity compared to the control group. Quality of life scores also improved significantly in the intervention group. Conclusion: A structured yoga intervention effectively enhances autonomic function and reduces PMS symptoms in medical students. Integrating yoga into wellness programs could provide a valuable, non-pharmacological approach for managing PMS and improving overall quality of life.

Objective: This study aims to evaluate the diagnostic sensitivity of magnetic resonance imaging on a wide range of pathologies affecting the ankle and the foot, including osseous, osteochondral, ligamentous, tendinous, and infectious and metabolic conditions. Methods: This is a retrospective study of a total of 250 MRI studies for patients that presented with ankle or foot pathology. The findings in imaging were grouped under specific anatomy regions and pathology types. The basic MRI protocols had T1-weighted, T2-weighted sequences with fat suppression, proton density, and STIR sequences in evaluating the different aspects including bone, cartilage, soft tissues, and inflammatory changes. All data from the images would be subjected to analyses based on how frequent they appeared and what their characteristic presentations looked like. Results: Osseous and osteochondral injuries were detected in 62% of cases, with a predominance of stress fractures and osteochondral lesions of the talus and calcaneus. Ligamentous injuries were identified in 53% of cases, where the most common injury involved the anterior talofibular ligament. Tendon pathologies, including Achilles and peroneal tendon issues, were present in 45% of cases, involving conditions like tendinosis, tendinitis, and subluxation. Infection and diabetic complications, including osteomyelitis and neuropathic osteoarthropathy, showed characteristic MRI features, which are important for timely diagnosis and management. Conclusion: MRI, however, is an excellent critical imaging tool for carrying a comprehensive assessment of any pathologies in the ankles or foot. It stands excellent with high diagnostic accuracy against a wide range of pathological situations. Its sensitivity in very early pathological changes and in further planning of appropriate management puts value to its clinical applicability.

Background: De Quervain’s tenosynovitis (DQT) is a common condition characterized by pain in the wrist and thumb, often affecting individuals engaged in repetitive hand movements. This study aims to compare the efficacy of steroid injections versus surgical release in treating DQT and to assess the demographic characteristics of affected patients. Methods: A prospective study was conducted at Hindu Rao Hospital over two years, involving 54 adults diagnosed with DQT. Participants were randomly assigned to receive either steroid injections or surgical release. Inclusion criteria included clinically diagnosed DQT with pain affecting daily activities, while those with inflammatory diseases, prior wrist injuries, or cognitive impairments were excluded. Data on demographics, treatment outcomes, complications, and recurrence rates were collected and analyzed. Results: The study population consisted of 42 females (78%) and 12 males (22%), with a mean age of 33 years. Both treatment groups showed similar outcomes, with no significant differences in complications or recovery rates. Complications were reported in 17% of patients, including hypopigmentation and numbness. The findings suggest that both steroid injections and surgical release are effective treatment options for DQT. Conclusion: This study underscores the high prevalence of DQT among females and highlights the effectiveness of both treatment modalities. Given the comparable outcomes, treatment choice may depend on patient preference and severity of symptoms, emphasizing the need for individualized management strategies in clinical practice.

Introduction: 70 to 80% of individuals suffer from low back pain related to prolapse of the lumbar disc, particularly among young, active workers. The condition results in a great deal of pain, sciatica, and impairments in motor function development which has become more severe as a global healthcare issue. Though conservative therapies prove useful, instances of surgery, for example, fenestration discectomy, promise efficient alleviation from such conditions with less morbidity, adequate recovery durations, and better quality of life outcomes in the longer term. This study evaluates the functional outcomes of lumbar disc prolapse patients after fenestration discectomy surgery. Method: This prospective cohort study, conducted in Hindu Rao Hospital, Delhi, from June 2019 to June 2021, investigated the outcomes of fenestration discectomy in 30 patients presenting with lumbar disc herniation. Patients were included if MRI definitively diagnosed lumbar disc herniation with radicular symptoms, thus forming a relatively homogenous cohort of subjects and yielding the most reliable outcome results. Result: It comprised only 30 patients with lumbar disc prolapse, of which the largest age group was predominantly male and aged forty-one to sixty. The most commonly affected disc level was L4-L5. After fenestration discectomy, 63.33% achieved an excellent outcome, 30% had a good result, and 6.67% had a fair recovery outcome, suggesting that fenestration discectomy has a valid role in enhancing functional independence. Conclusion: This study concluded that fenestration discectomy improves functional outcomes in patients with lumbar disc prolapse. It had no complications, reduced recovery time, and favourable results, though the small sample size limits the findings.

Aims & Objectives: To investigate anemia in patients with newly diagnosed pulmonary tuberculosis and association between anemia patients’ hemoglobin levels and the severity of their pulmonary tuberculosis. Methods: The present hospital-based study was conducted for one year (January 2023 to December 2023) on 100 pulmonary tuberculosis patients who attended Emergency, IPD, OPD of Muzaffarnagar Medical College and Hospital. The samples were tested using an automated cell counter that measured all relevant parameters, such as hemoglobin, hematocrit, red blood cell count, MCV, MCH, and MCHC. Results: Anemia was present in maximum study subjects (66%) and showed a statically significant value (p=0.002). Of the total 66 anemic subjects, 41 (62.12%) had normocytic normochromic anemia, 18 (27.27%) had hypochromic microcytic summary 51 anemia, 7 (10.61%) had hypochromic normocytic and no subject had macrocytic anemia, showing a statistically significant value (p=0.001). Sputum positivity for AFB grade showed a statistically significant difference between anemic and non-anemic subjects (p<0.01). Conclusion: The study concluded that a significant proportion of TB patients had anemia. The results of the study indicate that anemia is particularly common in patients with the most severe clinical forms of tuberculosis (TB), and that it may be utilized as a biomarker of the severity of tuberculosis. Anemia was substantially correlated with grade of AFB.

Aim: This study is aimed to detect the efficacy of Tzanakis scoring system in diagnosing acute appendicitis in our set up using histopathology as the gold standard. Materials and Methods: This cross-sectional validation study was carried out in ESIC Medical College & Hospital, Kalaburagi from October 2023 to October 2024, after approval from the Ethics Committee of the Hospital. The study included all adult patients of either gender who presented with clinical findings suggestive of acute appendicitis, who were assigned Tzanakis score pre-operatively and who subsequently underwent emergency appendicectomy with histological examination of the resected specimens.  Result: Sensitivity of Tzanakis score in diagnosing acute appendicitis was 91.3%, specificity 57.14%, positive predictive value 93.33%, negative predictive value 50% and diagnostic accuracy was 86.79%. The area under the curve (AUC) of the receiver operator characteristic (ROC) curve for the Tzanakis scoring system was 0.742, with a standard error of 0.083, 95% confidence interval- 0.579 – 0.906, p value = 0.004. Conclusion: This study concluded that the Tzanakis scoring system is acceptable for diagnosing acute appendicitis.

Background: Psoriasis is a persistent inflammatory condition that primarily impacts the skin, nails, and joints. While ocular manifestations are relatively uncommon in the existing literature, particularly among those with psoriatic arthritis. This study aimed to investigate the prevalence and characteristics of eye involvement in individuals diagnosed with psoriasis. Materials and Methods: The study included 134 individuals with psoriasis compared with 134 healthy participants. A comprehensive history was obtained for all participants, followed by dermatological, systemic, and ophthalmological assessments. Schirmer’s test and tear breakup time (BUT) were performed. Continuous variables were analyzed using the t-test, while categorical data were compared using the chi-square test. Logistic regression analysis was employed to explore associations between ocular findings and variables. Statistical evaluations were conducted separately for the right and left eyes. Results: Patients with psoriasis exhibited a significantly higher frequency of ocular findings in both eyes compared to the control group. Additionally, Schirmer’s and BUT values were markedly reduced in psoriasis patients compared to the controls. Conclusion: The findings underscore the importance of regular ophthalmological evaluations in patients with psoriasis for timely detection and management of ocular complications. However, further research is needed to elucidate the underlying mechanisms of ocular involvement in this patient population.

Background: Stroke is a leading cause of morbidity and mortality worldwide, with inflammation playing a pivotal role in its pathogenesis. Serum ferritin, an acute-phase reactant and marker of iron metabolism, is linked to oxidative stress and inflammation, potentially influencing stroke outcomes. Studying its levels may provide insights into prognosis and therapeutic targets in stroke management. Aim and Objectives: To assess the level of serum ferritin in stroke patients admitted in tertiary care centre and to correlate the level of serum ferritin with the disease outcome in the patients. Materials and Methods: This study was conducted as a prospective Observational Study on Patients admitted in medicine ICU, tertiary care hospital, Bhopal, during the study period of 18 months i.e. from 1^st September 2022 to 29^th February 2024.  The clinical severity of stroke was  assessed using Canadian Stroke Scale at the time of admission and on the 6^th day of admission, the severity of stroke was re-assessed clinically using CSS and serum ferritin levels were again measured in all the subjects. Results: Mean serum ferritin levels in patients with admitted with stroke at the time of admission was 276.30±155.52 ng/ml whereas that at day 6 was 301.95±228.86 ng/ml. 51 cases (31.9%) with stroke deteriorated over the hospital stay. Mean serum ferritin levels in deteriorated group was significantly higher as compared to non-deteriorated group (p<0.05). Serum ferritin at day 6 to be good predictor of adverse outcome i.e. deterioration as per CSS (AUC=0.897; 95% CI-0.842-0.951; p<0.05) and serum ferritin at admission was found to be fair predictor of adverse outcome (AUC=0.798; 95% CI- 0.723-0.873; p<0.05). Conclusions: Serum ferritin levels are prognostic marker of severity of stroke as well as outcome in patients with stroke. Elevated serum ferritin  is strongly positively correlated with early neurological deterioration in stroke patients. Elevated serum ferritin, a marker of iron stores, thus not only help in predicting short term and long term prognosis but signals the need for more intensive patient care and management protocols.

Background and Objectives: Uterine fibroids are common in reproductive-aged women, and their presence during pregnancy can lead to various complications. (1) To evaluate the clinical outcomes and complications in pregnant women with uterine fibroids. (2) To determine the type of delivery and its association with fibroid characteristics. Fibroid (myoma) is the most common benign tumors of the uterus. Effect of pregnancy on myoma may be stimulatory and it can lead to unpredictable and impressive growth during pregnancy. These tumors respond differently in different women. Fibroids may grow, regress or remain unchanged in size during pregnancy. Though in some cases it does not affect the outcome of pregnancy but they are associated with complications like preterm labor, IUGR, abortion, PROM, uterine dysfunction, placental abruption, and obstructed labor, increased risk of cesarean delivery, breech presentation, malposition. Hence based on above findings the present study was planned for Clinical Assessment of Complications & Type of Delivery in Pregnant Females Diagnosed with Fibroid Uterus. The data generated from the present study concludes that pregnancy with Fibroids is considered High-Risk. Timely diagnosis and tertiary care referral and Management of Antepartum, Intrapartum, Postpartum complications with good neonatal care leads to successful outcome. Caesarean Myomectomy in selected cases can prove beneficial.

Background: Glycated haemoglobin (HbA1c) is considered as a gold-standard measure of chronic glycemia in diabetic patients. HbA1c is a main indicator for mean blood glucose level. Dyslipidemia especially high LDL is common in diabetes mellitus and is strongly associated with poor glycemic control. Method: A study was carried out to determine the LDL levels in newly diagnosed type 2 diabetics in Jhalawar Rajasthan population. A total of 80 newly diagnosed type 2 diabetics were enrolled in our study. Result: In our study, maximum patients (53.75%) were from 46-60 years followed by 25% patients who were more than 60 years, and 21.25% patients were less than 45 years of age. HbA1c is significantly directly proportional to LDL level Conclusion: It was concluded from the results of this study that type 2 diabetic patients are more prone to dyslipidemia. In newly diagnosed type 2 diabetes mellitus, high LDL levels were found in patients with high HbA1C levels.

Background: To study found the incidence of type of post operative wound infection in uncomplicated acute appendicitis cases using prophylactic post operative antibiotics. Methods: This randomized control prospective study conducted on cases of uncomplicated acute appendicitis undergoing emergency open appendectomy were included in this study. Results: All the 9 patients who had wound infection developed superficial surgical site infection. None of the patients developed deep surgical site or intra-abdominal infections in either of the two groups. Conclusion: Frequency of post operative wound infection is generally very low in uncomplicated appendicitis. The prolonged use of antibiotics post operatively is unnecessary, can increase antibiotic resistance, can produce side effects, and increase cost of treatment.

Background: The aim of this study was to explore the study of thyroid function in patients with metabolic syndrome. Methods: This cross-sectional study was conducted on 200 patients with metabolic syndrome (MetS) (National Cholesterol Education Program’s-Adult Treatment Panel III Criteria) in the study group and 100 subjects without metabolic syndrome in the control group. Anthropometric variables and blood pressure were taken using standardized technique and body mass index was calculated. TSH, T4 and T3 were measured using electrochemiluminescence immuno assay. Results: The overall prevalence of thyroid dysfunction in patients with MetS was 44.00% with high prevalence of sub clinical hypothyroidism (28%). Conclusion: Hypothyroidism brawny associated with components of metabolic syndrome.

Background: Pott’s fractures, particularly in the context of unstable ankle injuries, pose significant challenges in orthopedic practice. Surgical intervention, specifically open reduction, and internal fixation (ORIF) is often required to restore joint stability and function. This study evaluates the outcomes of surgical management in closed bimalleolar ankle fractures. Methods: This prospective study involved 30 patients with closed bimalleolar ankle fractures, managed surgically at SRG Hospital and Medical College, Jhalawar, from April 2022 to January 2024. Patients were assessed for postoperative complications, functional outcomes using the Olerud-Molander Ankle Score, and time to radiological union. Results: The majority of patients (83.33%) experienced no postoperative complications. Functional outcomes were favourable, with 40.00% of patients achieving an excellent score and 33.33% achieving a good score. Radiological union was observed in 73.33% of patients within 8-10 weeks, indicating a rapid recovery associated with surgical intervention. Conclusion: ORIF is an effective approach for managing closed bimalleolar ankle fractures, offering excellent functional recovery, minimal complications, and a swift return to mobility. Surgical intervention should be prioritized in cases of unstable ankle fractures to optimize patient outcomes.

Background: Aromioclavicular (AC) joint dislocations are common injuries and compose a sizeable portion of shoulder injuries. Methods: The clinical and radiographic outcomes of 29 consecutive patients (20 men and 09 women) who underwent anatomic reduction for acute ACJ dislocation using two suture anchors for CC ligament reconstruction and two strands of non-absorbable stitches for ACJ fixation. Two 3.5 mm suture anchors with double-loaded sutures were separately inserted into the anterolateral and posteromedial portions of the coracoid process. The suture strands were passed through the hole created in the clavicle using 2.0 mm drill and tied over the clavicle. Additional ACJ augmentation using two strands of non-absorbable heavy sutures was performed in all patients. At 3, 6, and 12 months and last follow-up visit, the scores on the visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) score, Constant–Murley score, and simple shoulder test (SST) questionnaires were used to provide a final evaluation of shoulder function. Comparison between baseline and treatment results was performed. Radiographic analysis included vertical displacement and horizontal shift. Results: The mean preoperative, 3-month, 6-month, and 12-month follow-up evaluation ASES scores were 43.25±5.23, 75.69±6.29, 92.02±5.09, 93.25±7.29 respectively. The ASES score at 12 months postoperative was 48 higher than the preoperative ASES score (P < 0.01). There was no significant difference in ASES score between the 6- and 12- month follow-up evaluations (P > 0.05). The mean preoperative, 3-month, 6-month, and 12-month postoperative SST were 2.08±0.68, 8.12±1.21, 10.08±2.01respectively. The SST at 12 months postoperative was 10 higher than the preoperative SST (P < 0.01) between the baseline and 12-month follow-up data. No significant difference between the 6- and 12-month follow-up evaluations could be found (P > 0.05). The mean preoperative, 3-month, 6-month, and 12-month postoperative CMS were 30.18±4.26, 70.25±5.26, 88.27±3.28, respectively. The CMS at 12 months postoperative was 60 higher than the preoperative CMS (P < 0.01) between the baseline and 12-month follow-up data. No significant difference between the 6- and 12-month follow-up evaluations could be found (P > 0.05). Conclusions: CC ligament reconstruction using two suture anchors and ACJ augmentation using two strands of nonabsorbable heavy sutures on high-grade AC dislocation is a reliable technique for restoring stability to the ACJ and can obtain good to excellent clinical results.

Background: Our aim in this study is to examine the effects of fracture type on restoring mobility in the postoperative period. Methods: In this observational study, 100 consecutive patients over the age of 65 who were admitted to the hospital with hip fractures were examined. Hospital digital records were examined and patients’ age, gender, body mass index (BMI), smoking, American Society of Anesthesiologists (ASA) score, comorbidities (cardiovascular, respiratory, renal, neurological diseases and malignancy), fracture type, type of implant used in surgery and Charlson comorbidity index score were recorded. Result: 100 patients were included in the study. 62 patients were female and 38 were male, with a mean age of 78.23±8.31 years. There 61 patients were intertrochanteric fractures and 39 were femoral neck fractures. 12 patients underwent proximal femoral nail (PFN), 72 patients underwent hemiarthroplasty, 13 patients underwent dynamic hip screw (DHS) and 3 patients underwent total hip arthroplasty. In the analysis performed to determine the level of mobility, it was found that 96 patients moved without the use of an aid and 4 patients moved with the use of an aid in the pre-fracture period. In the sixth month postoperative follow-up, it was observed that 61 patients were ambulated without the use of an aid, 25 patients were ambulated with the use of an aid, and 14 patients were immobile. Conclusion: Advanced age, high ASA score, cardiovascular disease or malignancy among comorbidities, intertrochanteric fracture as fracture type, and use of PFN as implant type were the main risk factors for not regain to pre-fracture mobility and ADL.

Background: The present study describes the clinical presentation of enteric fever at a tertiary care centre. Methods: The study was a hospital based prospective observational study conducted on children of age 2 -18 years who presented with fever of 5 days or more with clinical signs and symptoms suggestive of typhoid fever and positive Widal test or Typhi dot tests were included in the study. The demographic and clinical features of the patients were described. Results: All the children presented with fever as the main complaint (100%). Commonest sign noticed was toxic look (84%) followed by coated tongue (79%) and splenomegaly (61%). Hepatomegaly was also noted in 34% of cases. Conclusion: This study was undertaken to observe the clinical profile of typhoid fever in children admitted in a tertiary care hospital. Typhoid fever remains to be as an endemic disease in this locality. All the signs and symptoms of the disease are nonspecific common with other acute febrile illnesses; a definitive diagnosis of the disease is required for treatment and to prevent transmission.

Fractures of the distal humerus in adults represent about 2% of all fractures and make up a third of humerus fractures. These injuries are particularly challenging due to their location near the joint, the small size of the distal bone fragments, and the reduced bone quality in older adults. This study aims to assess the clinical, radiographic, and functional outcomes of using a pre contour extra- articular humerus plate for extra-articular distal third humerus fractures, utilizing a posterior triceps splitting approach. Method: This prospective study was conducted at Jhalawar Medical College, Jhalawar, involving 15 consecutive skeletally mature patients with closed extra-articular distal humerus fractures. These fractures were treated using a pre contour extra- articular humerus plate, and the outcomes were evaluated based on radiological evidence of healing, functional results, and any complications that arose. Result: The use of a pre contour extra- articular humerus plate resulted in predictably high union rates and excellent patient outcomes without any implant-related complications. Conclusion: We recommend the use of a pre-contoured extra articular plate for these humerus fractures due to its consistent results in fracture union, stability across the fracture site, and the facilitation of early mobilization, leading to better functional outcomes.

Background: Distal radius fracture is one of most common fractures seen in clinical practice. Intra- articular comminuted fractures are usually associated with road traffic accidents, fall from height in young patients. In old age groups it is associated with severe osteoporosis due to trivial fall. All intra-articular fractures need good reduction for better functional outcome. The aim of our study is to evaluate the functional outcome of intra-articular comminuted distal end radius fractures treated with Ligamentotxis and pinning. Methods: This study was conducted in Orthopaedic Department of Jhalawar Medical College, Jhalawar, Rajasthan between March 2022 to April 2024 on 40 patients with intra-articular comminuted distal end radius fracture, who fulfilled the inclusion criteria. All fractures were managed by ligamentotaxis and pinning and were followed regularly and assessed after three months post- operatively for their final functional outcomes. Results: Overall, 40 patients of intra-articular comminuted distal end radius fractures treated by ligamentotaxis and pinning. 70% of the study population were males. According to Gartland and Werly score, 50% patients achieved excellent outcomes, 25% had good outcomes, 15% had fair outcomes, and 10% had poor outcome. Conclusion: Ligamentotaxis and pinning is safe and effective method of treatment for intra-articular comminuted distal end radius fracture. It is also cost-effective method and can be practiced even in small hospital.

Background: Dengue is the most important arthropod-borne viral infection of humans. Methods: The hospital-based study was conducted on patients presenting to paediatric hospital, who fulfilled inclusion and exclusion criteria. Results: According to complications, in dengue positive cases, bleeding was the most common complication seen in 47.00% cases while shock, myocarditis, and convulsion were present in 33.00%, 4.00% and 1.00% of cases respectively. Among the dengue negative cases, 58.00% had no complication while shock and bleeding were present in 29% and 13.0. Conclusion: It concluded that shock was most common complication.

Introduction: Diabetic foot is complex, chronic wounds, which have a major long-term impact on the morbidity, mortality, and quality of patients’ lives. Material and Method: Hospital based prospective study. 50 patients reporting to the Surgery dept. within study duration and eligible as per inclusion criteria will be included in the study. Results: Maximum 30% patients were treated through debridement of Diabetic foot whereas 20% patients received Slough Excision, Dressing & Skin graft and Toe Amputation as treatment modality. 18% patients were treated by I&D. amputation was the least used treatment modality. Conclusion: Diabetes Mellitus is a lifelong disease and diabetic foot complications can be life threatening, physically incapacitating, costly to treat and result in extensive morbidity.

Introduction: High levels of lipoprotein(a) [Lp(a)] are associated with increased risk of acute coronary syndrome (ACS). We explored whether Lp(a) exhibits a stronger association with ACS. Methods: Hospital based cross-sectional study. Was conducted on 100 patients with acute coronary acute coronary syndrome (ACS). The serum lipo-protein(A) level was measure and ECG was done at the time of admission and repeated, as necessary. Lp (a) was measure by agglutination. Results: 49.00% patients were belong to age group 41-60 Yrs followed by 47.00% patients were more than 60 Yrs age group. 53.00% patients were male, and 47.00% patients were female. 50.00% patients were belong to middle socio-economic status and 40.00% patients were belong to upper socio-economic status. 58.00% patients were obese followed by 37.00% patients BMI was normal, and 5.00% patients were morbid obesity.31.00% patients were present with positive family history. 36.00% patients were present with positive smoking history. 30.00% patients were present with positive Tobacco chewing history. 25.00% patients were present with positive alcohol history. SBP was 128.02±11.06 mm of hg and DBP was 80.02±8.01 mm of hg.  FBS was 110.06±19.36 mg/dl and PPBS was 165.39±34.02 mg/dl. Serum cholesterol was 185.36±43.28 mg/dl, Serum triglyceride was 151.23±60.35 mg/dl, LDL was 107.58±36.24 mg/dl and HDL was 44.23±7.14 mg/dl.  lipo-a was 51.77±11.23mg/dl. The association between age and lipo-protein a level was found statistically significant. The association between sex and lipo-protein a level was found statistically Insignificant. Conclusion: Lp(a) seems to be an independent risk factor for acute coronary syndrome (ACS), and high Lp(a) levels increased the risk for acute coronary syndrome (ACS).

Background and Objectives: Iron deficiency without anemia has been well-documented in heart failure, but its impact on chronic obstructive pulmonary disease (COPD) remains underexplored. The association of iron deficiency with disease severity, functional status, and quality of life in COPD warrants further investigation. This study aimed to evaluate the relationship between iron deficiency and clinical outcomes in non-anemic COPD patients, comparing disease severity, functional status, and quality of life between iron-deficient and iron-replete groups. This observational, cross-sectional study included non-anemic COPD patients with no history of bleeding. Participants were classified into iron-deficient (ID) and iron-replete (IR) groups based on serum iron, ferritin, and Total Iron Binding Capacity (TIBC) levels. Clinical assessments included 6-minute walk distance (6MWD), spirometry and Exacerbation. Demographic data, smoking history, and hemoglobin levels were also recorded. Materials and Methods: 110 patients with a confirmed diagnosis of COPD were enrolled at the Institute of Respiratory Diseases, Sawai Man Singh Medical College, Jaipur, Rajasthan, India. Data on demographic, clinical, Hematological and spirometry parameters were collected. Statistical analysis for qualitative data were done by applying chi square test whereas quantitative data were done by applying ‘t’ test. Data were collected and compiled with the help of MS Excel and analyzed using SPSS version 25.A p-value of <0.05 considered as statistically significant. Results: Iron-deficient individuals had significantly lower hemoglobin and iron levels, and higher TIBC compared to non-iron-deficient counterparts. Notably, NAID is associated with more severe grades of COPD, lower 6-minute walk distances and higher exacerbation rates, although no significant differences were observed in other respiratory parameters. These findings suggest that iron deficiency may contribute to the clinical severity of COPD and support the need for further research into the potential therapeutic benefits of addressing iron deficiency in this population.

Introduction: This study was conducted to compare the efficacy of ropivacaine and bupivacaine using a combined intraperitoneal and port-site administration to reduce the postoperative pain in patients undergoing laparoscopic cholecystectomy. Materials and Methods: Eighty patients scheduled for elective laparoscopic cholecystectomy with symptomatic cholelithiasis, 18-65 years, either gender, American society of Anesthesiologists (ASA) class I and II, were included. Patients were allocated into two group’s of40 each after randomization. Group R patients were given 0.375% Ropivacaine 35 mL [25 mL intraperitoneal plus 10 mL at port-site], while Group B patients were given 0.25% Bupivacaine35 mL [25 mL intraperitoneal plus 10 mL at port-site].Noninvasive blood pressure(NIBP),SpO2,Heart rate( HR), Respiratory rate(RR), Visual Analogue Scale(VAS) score and rescue analgesia were noted in post-operative period, at intervals of 0,1, 2, 4, 8, 12 and 24 hours respectively. Results: The demographic and clinical differences between two groups were not significant. The mean HR was comparable in both the groups, except at 12th hour post-operatively where Group R had significantly lower heart rate. The mean SBP was also comparable between the two groups, other than the 4th and 12th hour respectively, Group R values being significantly lower. The mean Diastolic Blood Pressure (DBP) showed a significant reduction in Group R at 8th and 12thhour respectively. At all the time-intervals the VAS score was lower in Group R, up to 12^th Hour, at the 12th hour significantly lower VAS scores were observed. In Group R a significantly lower number of rescue analgesia with a longer time for first dose of rescue analgesia was seen during the 24-hour postoperative period. Conclusion: In the early postoperative period as compared to 0.25% bupivacaine, 0.375% of ropivacaine provided good quality analgesia, having no adverse effects with less consumption of postoperative supplemental analgesics and can be incorporated in routine practice.

Background: Pregnancy is a physiological state in which significant changes in thyroid function occur. Several factors contribute to these changes. These factors could contribute to thyroid dysfunction during pregnancy especially when hormone levels undergo significant adjustments. This study aimed to assess thyroid function among pregnant women, tracking variations in thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels across different trimesters. Methods: A observational study was carried out on 90 pregnant women attending the Obstetrics Outpatient Department at Sri Krishna Medical College and Hospital, Muzaffarpur from August 2023 to July 2024, were invited to enroll in the study. At the end of the study, the blood samples were assessed for free T3, free T4 and TSH Levels. Results: This study revealed that most of the pregnant women had normal thyroid functions (51%), while subclinical hypothyroidism (38%) was the most prevalent disorder followed by Clinical hypothyroidism (7%) and hypothyroxinemia (4%). Conclusion: The most prevalent pattern of thyroid dysfunction in pregnant women was subclinical hypothyroidism. These findings highlight the importance of early thyroid function assessment and monitoring throughout pregnancy, underscoring the need for routine screening protocols to mitigate potential risks to both mother and child.

Background: Prehypertension is a medical condition marked by a slight elevation in blood pressure values, indicating an initial stage before the onset of clinical hypertension. Possible outcomes encompass physiological changes and an increased vulnerability to cardiovascular diseases. Applying yoga and meditation has shown beneficial results for physical and mental health. However, a limited amount of data is available on the impact of yoga treatment on specific signs and variables associated with prehypertension. This study investigates the influence of a well-organized yoga program on the cardiovascular workload of patients with prehypertension. Method: We enlisted participants aged 20 to 40 with accurate blood pressure readings. The therapeutic intervention involved the application of techniques such as relaxation, stretching, and breathing exercises. We evaluated the fundamental characteristics of the participants and examined the blood samples. Statistical tests were utilized for the analysis in this study. Result: This study evaluated the initial features of the participants. 80 individuals were allocated into two groups: 40 participants in the control group (CG) and 40 in the yoga group (YG). The physiological marker readings of the control group (CG) and yoga group (YG) were comparable. After three months, the group that practiced yoga had a greater reduction in cardiac risk profile measures than the control group (CG). Conclusion: The study findings suggest that participating in a three-month yoga program leads to positive changes in the parameters related to cardiovascular health, which are associated with the risk of heart disease. This suggests that implementing yoga can function as an effective non-pharmacological measure in improving cardiovascular health.

Background:  Head and neck cancer, the most common form of tumour in developing countries. For patients undergoing chemo-radiation for head and neck cancers, nutritional support is essential for minimizing side effects and enhancing treatment success. In contrast to home-based nutritional therapy, this study examines the impact of structured nutritional support on clinical and biochemical indicators. Methodology: Fifty patients with head and neck squamous cell carcinoma were included in an 18-month prospective observational research at NRI Medical College. Patients were randomized into two groups, with Group B receiving structured nutritional care and Group A receiving home-based nutritional support. Weight, haemoglobin, and albumin levels were among the clinical measurements, and treatment outcomes, side effects, infections, and re admissions to the hospital were assessed. Results: Structured nutritional support significantly reduced treatment interruptions (p=0.0308) and hospital re admissions (p=0.0047) compared to home-based care. Haemoglobin, albumin, and weight changes showed no statistically significant differences across groups (e.g., post-treatment haemoglobin p=0.4786). Group B patients tolerated treatment better, with fewer Grade 3 mucositis cases (4% vs 6%) and severe skin reactions (8% vs 4%). These findings underscore the importance of organized nutritional care during chemo radiation for improved outcomes. Conclusion: Patients receiving chemo-radiation therapy for head and neck cancers benefit from structured dietary support, which also lowers hospital re admissions and increases treatment adherence.

Introduction: Cervical cancer (CC) is the 4th most prevalent cancer among women in this global. Chronic HPV infections which mainly strains 16 and 18, raise cervical cancer risks, which requires showing from the age of 21. The treatment choices variety from cryotherapy in the early stages to brachytherapy and high-dose radiation therapy (HDRBT) in the final stages. These actions allow for precision tumor directing with least experience to healthy tissue, which finally recovers survival rates. Aim and Objectives: The goal of this study is to explore the clinical effectiveness and toxicity of two HDR brachytherapy dose treatments for cervical cancer therapy find the best balance between tumor control and side effects. Method: This 24-month study at NRI Medical College’s Department of Radiation Oncology examined two HDR brachytherapy routines for cervical cancer patients. Patients had simultaneous chemotherapy, external beam radiation treatment (EBRT), and one of two high-dose rate (HDR) dosage fractional process. Tumor control and toxicity were determined by clinical and imaging assessments. In addition, these results were classified with RECIST criteria, and toxicities were categorized using CTCAE guidelines. Result: The research assessed two high-dose rate brachytherapy protocols (Arm A:5.5 Gy; Arm B: 7 Gy) for cervical cancer. Both arms reached comparable local control rates (90%), with Arm A showing a marginal advantage in disease-free survival (100% vs. 95%). Arm B showed high acute bladder and rectal toxicity. Biologically effective doses (BED) were high in Arm B, resulting in heightened toxicity. Conclusion: This study concluded that Arm A has shown a slightly higher disease-free survival (DFS) rate (100%) compared to Arm B (95%), indicating a potential advantage in preventing disease recurrence.

url=”http://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue12,Article37.pdf” style=”3d” size=”4″ wide=”yes” center=”yes”]DOI: 10.5281/zenodo.[/su_button]

Background: Foramen transversarium (FT) is the special foramen located on the cervical vertebrae’s left and right transverse processes (C1 to C7) containing the vertebral vessels and sympathetic plexus.^1-3 It is an important and noticeable feature of the cervical vertebrae that occupies the sympathetic fibers, vertebral vein (VV), and vertebral artery (VA). Foramen transversarium gives passage to vertebral artery, vertebral vein and sympathetic plexus from inferior cervical ganglion while C7 vertebra transmits only the vein. The vertebrae of the cervical part and the proximal thoracic part of the human vertebral column are the area undergoing the most intense transformation during phylogeny, leading to many anatomical variations. Aim: Morphometric analysis of Foramen transversarium. Objectives: To Study Foramen Transversarium unilateral & Bilateral. Material and Methods: All the collected cervical vertebrae were examined macroscopically for the existence of the Foramen Transversarium in the 7th cervical vertebrae and the contents passing through it on both sides. All the cervical vertebrae were studied for the presence of more than one foramen and those with double foramen were photographed. In vertebrae with double foramen, the larger foramen was taken as the main foramen and the smaller foramen as the accessory foramen (AF). Digital vernier calipers of 0.01 mm precision were used for morphometric measurements. Vertebrae with this variation were photographed and noted. Results: Result of the 120 cervical vertebrae studied, 17 (14.1%) vertebrae were found to have double FT. Out of the 17 vertebrae, 14 vertebrae were typical and 3 were atypical cervical vertebrae. Among the 14 typical cervical vertebrae, 11 (78.5%) vertebrae had AF on the right side, 1 (7.1%) had on left side and 2 (14.2%) had bilateral AF. Among the three atypical cervical vertebrae, 2 (66.6%) had AF on the right side and 1 (33.3%) had bilateral AF. No AF was found in atlas and axis vertebrae. Conclusion: The present study has shown that Accessory Foramen is more common on the right side is smaller in size and is situated posterior to the main foramen. The knowledge of these variations will be useful in predicting variations in the course of the vertebral artery and will aid orthopedic surgeons for planning the posterior approach of cervical spines.

url=”http://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue12,Article38.pdf” style=”3d” size=”4″ wide=”yes” center=”yes”]DOI: 10.5281/zenodo.[/su_button]