Background: Basic Life Support (BLS) seeks to preserve respiration and circulation in cardiac arrest victims, emphasizing cardiopulmonary resuscitation (CPR) while utilizing minimal supplementary equipment. As per new Curriculum based medical education guidelines by National Medical Commission, foundation course for the Undergraduate has been started since 2019, in which skill component include 180 minutes for Basic Life Support. However, this much is not sufficient to learn about BLS and CPR. The elevated standards of care need that knowledge of BLS/CPR be updated and encompass both laypersons and medical professionals who may serve as educators in this skill. Objectives: The aim of the study was to evaluate the knowledge and attitudes of MBBS Phase – 1 medical students about Basic Life Support (BLS). Methods: This health education related descriptive, cross-sectional study was done by department of Physiology, among Phase 1 MBBS students of CIMS Chhindwara, MP, India, after institutional ethics committee approval. A Pre designed, pre-validated, self-reported questionnaire forms consisted of two sections were used for assessing the knowledge and attitude of MBBS students. Knowledge component assessment questionnaire form included questions related to steps of BLS, components of CPR and their details, sequence of CPR steps to follow, general awareness about examining pulse, respiration, etc. Attitude component assessment questionnaire form included questions related to CPR performed, willingness to learn BLS, willingness to teach BLS to family members, opinion on adding BLS training in medical and paramedical courses, etc. Data was entered in excel sheet. Means and proportions were calculated for quantitative & qualitative data respectively. Suitable statistical analysis done depending on the distribution of data. Results: Total number of sample size was 99 Phase 1 MBBS students. 98.99% of participants had poor knowledge, 1.01% of participants had average knowledge and none of the participant had good knowledge regarding Basic Life Support. Present study revealed a positive attitude of students towards BLS. Of the participants, 92.93% students have not done CPR before and 94% students feel that their knowledge about BLS is insufficient. 90.9% students think that all health care workers should be trained in BLS and 93.94% are likely to attend BLS training in workshop with hands on practice under supervision. Conclusion: The Study highlights that the knowledge of MBBS phase 1 students regarding BLS was not satisfactory. A significant portion of students do not acquire adequate knowledge in a single session of training in present curriculum. There is need to include frequent BLS training at regular intervals in medical curriculum of first year MBBS students. Progression of knowledge can also be done by inclusion of different teaching methods.

Background: Tibial shaft fractures are common orthopedic injuries, often resulting from high-energy trauma in younger individuals and falls in older adults. These fractures present a clinical challenge due to their complex nature and associated complications. Intramedullary nailing, particularly with the Expert Tibial Nail (ETN), has emerged as a preferred surgical technique for effective management. Methods: A prospective observational study was conducted over 18 months at a tertiary care hospital to assess the clinical outcomes of proximal tibia shaft fractures treated with intramedullary interlocking nailing using the ETN system. A total of 30 patients aged 18-75 were included, with follow-ups conducted at intervals up to six months post-surgery. Outcomes were evaluated using radiological assessments and functional criteria (Johner and Wruh’s). Results: The study demonstrated a high rate of successful outcomes, with 72% of patients achieving excellent functional recovery and 24% good results. Fracture healing times correlated with severity, ranging from 18 to 22 weeks. Early mobilization and partial weight-bearing were initiated within 11-12 weeks. Complications were minimal, with joint stiffness being the most frequent (10%). Conclusion: Intramedullary interlocking nailing with ETN is an effective treatment for proximal tibial fractures, offering superior functional and radiological outcomes. While complications such as knee stiffness and infection were observed, their incidence was low, emphasizing the importance of precise surgical techniques and early intervention.

Distal end radius fractures are among the most common upper extremity injuries, particularly in adults. The management of these fractures can vary significantly, with external fixation emerging as a viable option for cases that are displaced and complex. This article reviews the radiological outcomes of displaced distal end radius fractures treated with external fixators, emphasizing recovery metrics, patient satisfaction, and long-term implications.

Response to Ceftriaxone was assessed in resistant uncomplicated E. coli UTI cases as Ceftriaxone concentrates more than 10-fold in urinary bladder. 30 subjects were selected out of which 18 were females and 12 males. 14 resistant cases responded with a follow up negative culture and lowering of urinary pus cells and WBC counts whereas 3 resistant cases failed to respond. Out of 4 non-growers, 3 responded to CTO. This brings promise of initial treatment of uncomplicated UTI with Ceftriaxone prior to arrival of culture results.

Background: The thyroid gland synthesizes primarily two hormones, triiodothyronine (T3) and thyroxin (T4) which are vital to maintain numerous functions especially metabolic, mineral and thermogenic homeostasis in body. The disorders of thyroid function especially hypothyroidism is important it can cause of disturbance in Calcium & Phosphorus metabolism. Objectives: This study was designed to estimate serum T3, serum T4, serum TSH, serum Calcium and serum Phosphorus in hypothyroid patients and control subjects. Materials and Methods: After ethical committee approval, a case control study was conducted in the Department of Biochemistry in Govt. Medical College and associated group of Hospital, Kota (Raj.). A total of 144 subjects included in this study were divided into two groups – control and hypothyroid. Result: The significant (p < 0.001) decreased mean value of serum Calcium and serum Phosphorus in hypothyroid patients when compared with control subjects. Conclusion: In our study we found that serum Calcium and serum Phosphorus were altered in hypothyroid patients. Hence estimation of serum Calcium & Phosphorus may be supportive for better management to avert further problems from mineral metabolism dysfunction.

Aim: This study aimed to evaluate the effects of PRP on pain, joint function, and cartilage thickness in patients with knee OA over 12 months. Methods: In a randomized controlled trial conducted from 2020 to 2023 at IGIMS and PMCH in Patna, 100 patients with knee OA were assigned to either a PRP group (n=50) or a control group (n=50). PRP patients received three intra-articular injections, while controls received saline. Pain (VAS), function (WOMAC), and cartilage thickness (MRI) were measured at baseline, 3, 6, and 12 months. Results: PRP significantly reduced pain (p<0.001) and improved function (p<0.001) compared to control. MRI showed a modest increase in cartilage thickness in the PRP group, suggesting possible regenerative effects. Conclusion: PRP therapy provides effective pain relief and functional improvement in knee OA patients, with the potential for cartilage regeneration, indicating its promise as a non-surgical treatment option.

Introduction: Placenta previa and placenta accreta spectrum disorders are serious obstetric complications associated with increased maternal morbidity and mortality, largely due to postpartum hemorrhage (PPH). Intrauterine balloon tamponade (IUBT) has emerged as a less invasive method to manage severe PPH, potentially reducing the need for hysterectomy and preserving fertility. While included in treatment guidelines, the efficacy of IUBT varies across studies. This study evaluates the effectiveness of IUBT in cesarean deliveries complicated by placenta previa and placenta accreta spectrum. Material and Methods: This 12-month prospective study included women undergoing cesarean deliveries complicated by placenta previa or placenta accreta spectrum (PAS). Diagnoses were confirmed via ultrasonography, MRI, or intraoperative findings. Patients with coagulopathies, infections, or incomplete follow-up were excluded. IUBT was standardized using the Bakri balloon or equivalent devices, with data on usage, blood loss, and additional interventions systematically recorded. Statistical analysis was conducted using SPSS, with p < 0.05 considered significant. Results: In our study, intrauterine balloon tamponade (IUBT) was successfully used in 92% of cases with placenta previa and placenta accreta spectrum, with a peripartum hysterectomy rate of 8% and no maternal mortality reported. Blood transfusions were required intraoperatively in 60% of cases, postoperatively in 30%, and preoperatively in 10%, reflecting the severity of hemorrhage. Emergency cesarean sections accounted for 82% of cases, while 18% were elective. Among comorbidities, gestational hypertension was most common (26%), followed by diabetes (10%) and severe pre-eclampsia (5%). Neonatal outcomes showed a survival rate of 92%, with a mean birth weight of 2.372 ± 0.37 kg. Intrauterine fetal demise occurred in 5% of cases, early neonatal death in 4%, and 3% of neonates were referred to the SNCU, emphasizing the high-risk nature of these pregnancies. Conclusion: In conclusion, intrauterine balloon tamponade proved effective in managing postpartum hemorrhage in placenta previa and accreta spectrum cases, with a high success rate, low peripartum hysterectomy rate, and no maternal mortality. These findings highlight its role as a valuable, less invasive intervention in high-risk obstetrics.

Background: Cervical lymphadenopathy is a common clinical condition involving the enlargement of cervical lymph nodes due to various causes, including infections, malignancies, and systemic diseases. Its presentation often poses diagnostic challenges. This study explores the etiologies, clinical profiles, diagnostic approaches, and management strategies for cervical lymphadenopathy, aiming to improve patient outcomes through evidence-based interventions. Methods: Patients presenting with cervical lymph node enlargement. Data collection involved a structured proforma, which included detailed patient history, thorough clinical examination, and relevant investigations to establish a provisional diagnosis. Routine investigations included fine-needle aspiration cytology (FNAC) and blood tests. In cases where FNAC yielded inconclusive results, lymph node biopsy specimens were collected and subjected to histopathological examination (HPE). Results: The study included 40 cases, of which 24 were male (60%) and 16 were female (40%). A minority of cases (28.5%) had a history of tuberculosis contact. The most common site for reactive lymphadenitis was level I, while secondaries were most common at level II. All lymphoma cases were classified as Hodgkin’s lymphoma, with no cases of non-Hodgkin’s lymphoma. Squamous cell carcinoma (SCC) was the most frequent primary malignancy (13 cases), followed by papillary carcinoma of the thyroid (3 cases). FNAC demonstrated 100% sensitivity and specificity for diagnosing secondaries and lymphoma, with high sensitivity (85.7%) for tubercular cervical lymphadenitis and 100% specificity. Conclusion: This study provides valuable insights into the epidemiology and management of cervical lymphadenopathies. The findings highlight the diversity of etiologies, ranging from infectious causes, such as tuberculosis, to malignant conditions, such as metastatic squamous cell carcinoma. FNAC remains a highly effective diagnostic tool, and the treatment outcomes depend significantly on the underlying pathology.

Background: Management of severely calcified coronary artery disease (CAD) poses significant procedural challenges during percutaneous coronary intervention (PCI). Rotablation-guided PCI, which uses a high-speed rotational atherectomy device, has emerged as an important technique to facilitate stent deployment in these complex lesions. However, data regarding its safety outcomes, especially in resource-constrained settings, remain limited. Methods: We conducted a mixed-design cohort study in the Department of Cardiology at MDM Hospital (Dr. S.N. Medical College, Jodhpur) from January 2023 to December 2024. Consecutive patients aged >18 years with significant (>70% stenosis) calcified coronary lesions were included. Procedural details—particularly comparing radial (RRA) and femoral (RFA) access routes—were recorded. Immediate and 3-month post-hospital complications were assessed. Statistical analyses were performed using chi-square and t-tests, with p<0.05 denoting significance. Results: A total of 82 patients underwent rotablation-guided PCI. Baseline demographics and clinical characteristics were statistically comparable between RFA (60.98%) and RRA (39.02%) groups (p>0.05). The left anterior descending artery (LAD) was the most commonly treated vessel (78.05%). TIMI 3 flow was achieved in 100% of cases. Immediate complications included cardiac perforation (9.76%) and other minor complications (12.19%), with no statistically significant difference between access routes (p=0.368). All patients were free from post-hospital complications at the 3-month follow-up. Conclusion: Rotablation-guided PCI in calcified coronary lesions demonstrated favorable safety outcomes in this single-centre study, with no significant differences between radial and femoral access routes. The technique appears to be a safe adjunctive therapy in managing complex calcified lesions, enabling successful stent deployment and excellent short-term outcomes.

Background: Hemophagocytic lymphohistiocytosis is a deadly hyper inflammatory syndrome resulting from immune dysregulation. This study aimed to outline the clinical, pathological, and biochemical profiles of suspected HLH, comparing patients with pediatric and adult conditions; it also aimed to evaluate the diagnostic utility of the HLH-2004 criteria and the H-score. Methods: SCB Medical College, Cuttack, included 48 suspected HLH cases between September 2020 and October 2022. Clinical presentations, laboratory findings, and bone marrow examination were analyzed. The HLH-2004 diagnostic criteria and the H-score with a cut-off of ≥169 indicated probable HLH. Results: The percentage of adults was 77%, while the pediatric cases were 23%. The median age of pediatric cases was 7 years. Fever was the most common symptom (100%), followed by splenomegaly (39.6%) and hepatomegaly (29.2%). Ferritin levels were elevated in 81.8% of pediatric and 91.9% of adult cases. Bone marrow hemophagocytosis was present in 38.2%. According to HLH-2004 criteria, 22.9% of cases satisfied all diagnostic criteria, while 50% had an H-score ≥169. Infections were the most common trigger (47%), followed by autoimmune disorders and malignancies. Conclusion: It brings out the diagnostic challenge in HLH and says the value of employing combined criteria in diagnosing cases. More importantly, the earliest identification of HLH and its many precipitants give the largest benefit in terms of timely intervention and improved outcome.

Background: Fine-needle aspiration cytology (FNAC) has been one of the most common diagnostic techniques to assess thyroid lesions using minimal invasiveness and efficiency. It remains a worthwhile tool, although with limitations, primarily with respect to indeterminate categories, and thus warrants careful assessment of its diagnostic performance as well as its own limitations. Methods: This study analyzed 250 cases of thyroid lesions, correlating FNAC findings categorized using the Bethesda System for Reporting Thyroid Cytopathology with final histopathological diagnoses. The diagnostic accuracy, sensitivity, specificity, and rates of cyto histo concordance were calculated. Discordant cases were examined to identify sources of diagnostic errors. Results: The overall diagnostic accuracy of FNAC was 91.6%, with sensitivity and specificity of 89.7% and 93.0%, respectively. The highest concordance rates were seen in Bethesda II (94.5%) and Bethesda VI (97.0%) categories. Malignancy rates for indeterminate categories (Bethesda III and IV) were 31% and 40%, respectively, with lower concordance rates (69.0% and 60.0%). Sampling errors and misinterpretation of cytological features were the main causes of discordance. Cyto Histopathological correlation stressed the reliability of FNAC in diagnosing benign and malignant lesions while throwing a challenge in the indeterminate cases. Conclusion: FNAC is a good diagnostic modality for thyroid nodules but limitations in the indeterminate categories necessitate adjunctive diagnostic strategies, including molecular testing and sophisticated sampling techniques. Cyto Histopathological correlation is crucial for improving diagnostic accuracy and optimal management of the patient.

Background: Infectious disease epidemiology has experienced a profound transformation in response to the COVID-19 pandemic. Advances in molecular, genomic, and digital technologies have allowed better tracking of pathogen spread, improved causal inference, and enhanced public health decision-making. Methods: This review discusses the emerging trends in infectious disease epidemiology, including integration of genomic sequencing, digital surveillance systems, and advanced statistical methodologies. It covers the progressive use of predictive modeling, disease susceptibility through the human microbiome, and causal inference techniques in the evaluation of vaccines and antimicrobial therapies. Results: Integration of real-time genomic surveillance, digital health monitoring, and predictive modeling significantly improved the tracking and managing of infectious diseases. It has included a proof-of-concept of the monitoring of SARS-CoV-2 variants by applying genomic sequencing, an observation on the efficacy of the vaccine in preventing severe cases, and the increased interest of the microbiome’s influence on the susceptibility of individuals to infectious diseases. Critical insights on the need for hospitals during outbreaks have been made with predictive models, making it very efficient in health systems when outbreaks occur. Conclusion: The post-pandemic landscape highlights the call for innovative epidemiological approaches to infectious diseases. Incorporation of new data sources, refined statistical methods, and host-pathogen interactions into the study would shape public health strategies of the future. Continued research and advancement in technology will be crucial in addressing challenges and increasing preparedness of global health.

Background: Salpingitis is caused by ascending microbes from the lower reproductive tract and contributes to tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. The aim of this study was to analyze the risk factors associated with the cases of salpingitis and its relation with histopathology of fallopian tubes. Materials & Methods: This descriptive observational study was done at Department of Obstetrics & Gynaecology, North Bengal Medical College & Hospital; district Darjeeling over a period of one year (May 2018– April 2019). Study Population was women who had salpingectomy and tubal ligation at NBMCH. Specimens of salpingectomy from clients who underwent, tubal ligation or along with hysterectomy/oophorectomy were taken. Taking into consideration the fall out, we added 10% extra to the sample size. So the final sample size came to be 102.Gross abnormalities like paratubal cysts were encouraged to be taken in the specimen. Specimen was then preserved in 10% formalin, labelled properly and taken to Pathology Department of NBMCH. Results: Out of 102 cases, maximum cases (81) were contributed by ligation, ligation done during the caesarean being the highest. The chronic nonspecific salpingitis is accounts for 9.8% of the various histological findings. Of the total 10 cases, 6 were obtained after ligation, and the remaining 4 had ectopic pregnancy with the background of chronic salpingitis on histology. Amongst all cases of ligation done along with caesarean 80% had normal fallopian tube histology whereas only 6.4% had salpingitis. This proportion of salpingitis is higher in cases of MTP with ligation to around 20%. All the users of IUCD had normal tubal histology and 10% of non-users had salpingitis. The relation between the IUCD use and occurrence of salpingitis is statistically insignificant. Conclusion: The most common pathological lesion was chronic non-specific salpingitis (9.8%). Amongst cases of ruptured tubal ectopic pregnancy 44.4% were associated with chronic salpingitis. The relationship of history of dilatation and evacuation in past with chronic asymptomatic salpingitis is substantial (p value 0.02). However, the use of IUCD (p value – 0.41), use of OCP (p value – 0.62), any visit to STI clinic in past (p value – 0.25), had no significant relation with the occurrence of salpingitis.

Introduction: Adequate postoperative analgesia is critical following lower segment cesarean section (LSCS) to support early recovery, facilitate breastfeeding, and enhance maternal-infant bonding. The transversus abdominis plane (TAP) block has proven effective for postoperative pain management in abdominal surgeries. This study compares dexamethasone (4 mg) and magnesium sulphate (MgSO₄) (150 mg) as adjuvants to bupivacaine (0.25%) in TAP blocks for postoperative analgesia in LSCS. Materials and Methods: This triple-blinded randomised controlled trial included 60 patients undergoing elective LSCS, divided into Group D (bupivacaine + dexamethasone) and Group M (bupivacaine + MgSO₄). Both groups received bilateral ultrasound-guided TAP blocks following spinal anaesthesia. Pain intensity was assessed using the visual analogue scale (VAS), time to first analgesic request, total rescue analgesia required, hemodynamic stability, patient satisfaction, and side effects over 24 hours. Statistical analyses were performed using SPSS version 26.0. Results: Group D demonstrated a significantly longer time to the first analgesic request (800 ± 60 vs. 620 ± 55 minutes, p < 0.001) and reduced tramadol consumption (1.0 ± 0.4 vs. 1.8 ± 0.6 doses, p < 0.001). VAS scores at rest and movement were consistently lower in Group D at all time intervals (p < 0.01). Hemodynamic parameters remained stable in both groups, with minimal side effects. Patient satisfaction was higher in Group D (86.7% “highly satisfied” vs. 63.3%).

Conclusion: Dexamethasone as an adjuvant to bupivacaine in TAP blocks offers superior postoperative pain control, reduced analgesic requirements, and higher patient satisfaction than MgSO₄, with a comparable safety profile.

Introduction: Spinal surgeries often involve significant blood loss due to extensive dissection and vascularized bone exposure, leading to postoperative anaemia, increased transfusion requirements, and heightened infection risk. Tranexamic acid (TXA), an antifibrinolytic agent, has proven efficacy in reducing perioperative blood loss across surgical disciplines. However, optimal dosing in spine surgeries remains unclear. This study evaluates the effectiveness and safety of varying TXA doses (10 mg/kg, 15 mg/kg, and 20 mg/kg) in minimizing intraoperative and postoperative blood loss and transfusion needs. Materials and Methods: A prospective, randomised study was conducted at Mamata Medical College, Telangana, involving 75 patients undergoing elective spine surgeries. Participants were assigned to receive TXA intravenously at 10 mg/kg, 15 mg/kg, or 20 mg/kg. Blood loss was measured intraoperatively and postoperatively (24 hours), while transfusion requirements, hemodynamic parameters, and adverse events were recorded. Statistical analysis included ANOVA and chi-square tests, with a significance threshold of p < 0.05. Results: Group C (20 mg/kg) demonstrated the least intraoperative (350 ± 30 mL) and postoperative blood loss (150 ± 10 mL), compared to Groups A (650 ± 50 mL, 300 ± 20 mL) and B (480 ± 40 mL, 220 ± 15 mL) (p < 0.05). Transfusion requirements were significantly lower in Group C (4 patients) than in Groups A (16) and B (10) (p = 0.002). No major thromboembolic events were observed. Conclusion: A TXA dose of 20 mg/kg effectively minimizes blood loss and transfusion needs during spine surgeries without increasing adverse events, supporting its use for optimal perioperative blood conservation.

Introduction: Pain management in femur fractures is critical to alleviating discomfort and preventing complications such as muscle spasms and neurogenic shock. While systemic analgesics like paracetamol and tramadol are widely used, their side effects limit their utility. Ultrasound-guided lateral femoral cutaneous and femoral nerve blocks (LFCN+FNB) offer a promising alternative by providing precise, regional analgesia with minimal systemic effects. This study compares the efficacy of LFCN+FNB versus intravenous paracetamol and tramadol in managing pain for femur fractures. Materials and Methods: This prospective, randomised comparative study included 60 adult patients (18–65 years, ASA I–II) with femur fractures undergoing surgical fixation at Mamata Medical College from July 2023 to July 2024. Patients were divided into two groups (n=30 each): Group A received ultrasound-guided LFCN+FNB, and Group B was administered intravenous paracetamol (1 g) and tramadol (100 mg). Pain scores (NRS) were recorded at 0, 6, 12, and 24 hours. Secondary outcomes included time to first analgesia, total analgesic consumption, side effects, hospital stay, and QoR-15 scores. Statistical analyses were performed using SPSS v26.0. Results: Group A showed significantly lower pain scores at all time points (p<0.001), extended time to first analgesia (10.5 vs. 4.2 hours, p<0.001), reduced total analgesic consumption (50 mg vs. 150 mg, p<0.001), and shorter hospital stay (4.8 vs. 5.5 days, p=0.006). Group A also demonstrated lower nausea rates (3.3% vs. 20%, p=0.044) and higher QoR-15 scores (130.5 vs. 120.3, p<0.001). Conclusion: Ultrasound-guided LFCN+FNB offers superior pain relief, reduced analgesic use, and enhanced recovery compared to paracetamol and tramadol, highlighting its efficacy and safety for femur fracture management.

Introduction: Intertrochanteric fractures are a common and serious issue in geriatric patients, necessitating adequate postoperative analgesia to facilitate early mobilisation and improve outcomes. Traditional systemic analgesics such as opioids and NSAIDs pose significant risks in this population, prompting the need for alternative strategies. Regional anaesthesia, specifically combined femoral and lateral femoral cutaneous nerve blocks (FNB + LFCNB), has shown promise. This study compares the efficacy of FNB + LFCNB versus intravenous paracetamol for postoperative pain management in geriatric patients with intertrochanteric fractures. Materials and Methods: A prospective, randomised, controlled trial was conducted at Mamata Medical College with 60 geriatric patients undergoing surgery for intertrochanteric fractures. Participants were randomised into two groups: one receiving FNB + LFCNB using bupivacaine and the other intravenous paracetamol. Pain was assessed using the Visual Analog Scale (VAS) at 6, 12, and 24 hours postoperatively. Secondary outcomes included analgesic consumption, time to ambulation, hospital stay duration, and adverse events. Statistical significance was set at p < 0.05. Results: The FNB + LFCNB group demonstrated significantly lower VAS scores at rest and during movement (p < 0.05) and required less supplemental analgesia (12.4 ± 3.8 mg vs. 22.6 ± 4.5 mg, p < 0.001). Time to ambulation and hospital stay were shorter, and the nerve block group had higher patient satisfaction scores. Side effects were fewer and not statistically significant. Conclusion: Combined femoral and lateral femoral cutaneous nerve blocks provide superior analgesia, faster recovery, and better functional outcomes than paracetamol in geriatric patients with intertrochanteric fractures, supporting their broader clinical use.

Introduction: Neuromuscular blocking agents (NMBAs) are integral to modern anaesthesia but carry postoperative residual neuromuscular blockade (PRNB) risks, leading to complications like respiratory distress. Neostigmine, traditionally used for NMBA reversal, has limitations, including delayed recovery and muscarinic side effects. Sugammadex, a selective relaxant-binding agent, offers rapid and predictable reversal, potentially enhancing safety and efficiency. This study evaluates the efficacy and safety of Sugammadex compared to neostigmine in adult surgical patients. Materials and Methods: Sixty adult patients undergoing elective surgery under general anaesthesia were randomised into Sugammadex (Group S, n=30) and neostigmine with glycopyrrolate (Group N, n=30). Neuromuscular function was monitored using acceleromyography. The primary outcome was the time to achieve a Train-of-Four (TOF) ratio ≥ 0.9. Secondary outcomes included PRNB incidence and adverse events. Data were analysed using independent t-tests and chi-square tests, with p<0.05 considered significant. Results: Sugammadex achieved significantly faster recovery to TOF ≥ 0.9 (2.1 ± 0.5 minutes) compared to neostigmine (12.8 ± 3.2 minutes, p<0.001). PRNB occurred in 43.3% of Group N patients but was absent in Group S (p<0.001). Postoperative nausea and vomiting were more frequent with Sugammadex (23.3% vs. 6.7%, p=0.071). Urinary retention and dyspnoea were noted only in Group N. Both agents were well tolerated, with no serious adverse events. Conclusion: Sugammadex demonstrates superior efficacy in rapidly reversing NMB and reducing PRNB incidence compared to neostigmine. Despite higher costs, its favourable safety profile and operational benefits position it as a transformative agent in perioperative care. Further, multicentre studies are warranted to validate these findings.

Introduction: Postoperative pain management in shoulder surgeries, such as arthroscopic procedures, is crucial for recovery and early rehabilitation. Interscalene block (ISB) with bupivacaine is effective but limited by its short duration of action. Adjuvants like dexamethasone and dexmedetomidine have shown promise in prolonging analgesia. This randomised controlled trial aimed to compare the efficacy and safety of these adjuvants in ISB. Materials and Methods: The study was conducted at Mamata Medical College, Khammam, India, with 60 patients undergoing elective shoulder surgeries. Participants were randomised into two groups: Group A received bupivacaine 0.5% (20 mL) with 10 mcg of dexmedetomidine, and Group B received bupivacaine 0.5% (20 mL) with 8 mg of dexamethasone. Pain was assessed using the Visual Analog Scale (VAS) at 6, 12, and 24 hours postoperatively. The duration of analgesia, adverse effects, and patient satisfaction were recorded. Statistical analysis was performed using SPSS version 25, with p < 0.05 considered significant. Results: Group A demonstrated a significantly longer analgesic duration (14.5 ± 2.3 hours vs. 12.8 ± 2.1 hours, p < 0.001) and lower VAS scores at 6, 12, and 24 hours postoperatively (p < 0.05). Patient satisfaction was higher in Group A (8.9 ± 0.8 vs. 8.4 ± 1.0, p = 0.005). Adverse effects were mild and comparable between groups, with no severe complications. Conclusion: Dexmedetomidine is superior to dexamethasone as an adjuvant to bupivacaine in ISB, offering longer analgesic duration, better pain control, and comparable safety. These findings support its use in postoperative pain management for shoulder surgeries.

Introduction: Emergency laparotomy for perforation peritonitis is a critical surgical procedure requiring swift diagnosis and management due to its significant morbidity and mortality risks. Peritonitis, a severe inflammation of the abdominal cavity, arises from various causes, including gastrointestinal perforations. Despite advancements in medical care, managing this condition remains challenging, particularly in resource-constrained settings. Objective: To evaluate risk factors influencing outcomes in patients undergoing emergency laparotomy for perforation peritonitis, focusing on clinical, biochemical, and intraoperative parameters to improve prognosis and management strategies. Methods: This hospital-based observational cohort study, conducted over 18 months, included 60 patients diagnosed with perforation peritonitis and treated with emergency laparotomy. Clinical presentations, biochemical markers, and intraoperative findings were analyzed. Exclusion criteria encompassed patients aged below 18 or above 65 years, those with postoperative anastomotic leaks, and those who declined consent. Outcomes were compared based on ICU admissions, mortality, and hospital stays. Results:  Middle-aged adults (51–60 years, 43.3%) were most affected, with a higher prevalence in females (61.7%). Common operative findings included duodenal ulcers (53.3%) and typhoid ulcers (26.7%). Elevated TLC, hypoalbuminemia, and raised CRP levels were significantly associated with poorer outcomes. ICU patients exhibited higher temperatures and pulse rates but lower systolic blood pressure. Non-survivors had significantly prolonged hospital stays, hypoalbuminemia (100%), and higher inflammatory markers. Conclusion: Perforation peritonitis predominantly affects middle-aged adults, presenting with abdominal pain, tenderness, and systemic signs of sepsis. Key prognostic markers include elevated TLC, hypoalbuminemia, and raised CRP, emphasizing the importance of early intervention and tailored care. Improved strategies for timely diagnosis and management are crucial to reducing morbidity and mortality.

Introduction: Local anesthetics (LAs) block pain signals by inhibiting sodium channels in nerve cells. Long-acting LAs like bupivacaine (BP) and ropivacaine (RP) are preferred for extended regional anesthesia. This study compares 0.5% BP and RP, evaluating sensory/motor blockade duration, efficacy, and adverse effects, including cardiotoxicity and neurotoxicity, to assess their safety profiles. Aim and Objectives: The aim of this study is to compare the duration of sensory and motor blockade, as well as the adverse effects, of 0.5% Ropivacaine and 0.5% Bupivacaine in patients undergoing brachial plexus anesthesia. Method: This randomized, double-blind study compared 0.5% bupivacaine (Group A) and 0.5% ropivacaine (Group B) in 60 ASA I/II patients aged 20-60 years. Following ethical approval and consent, patients received 25 ml of the assigned agent for supraclavicular brachial plexus block. Sensory and motor block onset/duration, vital signs, and adverse events were monitored to assess efficacy and safety. Result: The study compared 0.5% bupivacaine and ropivacaine in 60 patients, balanced for age, weight, and gender. Group A showed significantly longer sensory (446.43 min) and motor (406.97 min) block durations (p<0.001). Both groups maintained stable SPO2 (99.6-100%) and heart rates, with minimal differences, confirming comparable safety profiles and cardiovascular stability for both anesthetics. Conclusion: The study found ropivacaine had a faster onset of sensory and motor blocks, while bupivacaine provided longer block durations. Both anesthetics were effective, with no significant adverse events or vital sign changes.

Background: Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic gallstone disease. However, managing diabetic patients poses unique challenges due to the systemic effects of diabetes, including altered gallbladder motility, increased inflammation, and delayed wound healing. Understanding the intraoperative findings and outcomes of LC in diabetic patients is crucial for improving surgical care in this population. Aim: To assess how diabetes affects surgical complexity and recovery, as well as to compare the intraoperative findings and results of laparoscopic cholecystectomy in patients with and without diabetes. Methods: This prospective comparative study was conducted at Rani Durgavati Medical College, Banda, Uttar Pradesh, India, over two years, including 60 patients (30 diabetics and 30 non-diabetics). Data were collected on demographic characteristics, intraoperative findings (operative time, gallbladder wall thickness, adhesions, bile spillage), and postoperative outcomes (hospital stay, wound infections, complications). Statistical analysis was performed using SPSS version 23.0, with significance set at p < 0.05. Results: Diabetic patients had significantly longer operative times (75.2 ± 10.5 minutes vs. 65.3 ± 9.8 minutes, p < 0.001) and thicker gallbladder walls (4.8 ± 0.6 mm vs. 3.6 ± 0.5 mm, p < 0.001). Adhesions (60% vs. 27%, p = 0.012) and bile spillage (40% vs. 13%, p = 0.005) were more frequent in diabetics. Postoperative hospital stays were longer in diabetics (3.8 ± 1.2 days vs. 2.5 ± 0.8 days, p < 0.001), and patient satisfaction scores were lower (7.2 ± 1.5 vs. 8.4 ± 1.2, p = 0.021). Conclusion: Diabetic patients undergoing laparoscopic cholecystectomy exhibit increased surgical complexity and prolonged recovery times compared to non-diabetics. Despite these challenges, LC remains a safe and effective procedure for diabetic patients with appropriate perioperative management. Recommendations: Optimizing preoperative glycemic control, enhancing intraoperative techniques, and implementing tailored postoperative care protocols can improve outcomes for diabetic patients undergoing LC. Future studies should explore the role of advanced surgical technologies and protocols in mitigating the challenges observed in diabetic populations.

Background: Primary membranous nephropathy is an important cause of nephrotic syndrome whose outcome may vary from benign to end-stage renal failure. However, the role of serum Anti-Phospholipase A2 Receptor antibody in predicting the outcome remains under study. The present study assesses the predictive value for anti-PLA2R antibodies in terms of the clinical outcome of PMN. Methods: The prospective observational study was carried out from May 2021 to May 2023 in S.C.B. Medical College and Hospital, Cuttack. Forty-nine patients with biopsy-proven PMN and positive anti-PLA2R antibody tests were enrolled in this study. Clinical data at baseline and after six months of follow-up were collected. Key parameters such as serum creatinine, serum albumin, 24-hour urine protein, and eGFR were assessed. In the present study, the relationship of anti-PLA2R antibody level to clinical remission was evaluated in patients managed either conservatively or with immunosuppressive therapy. Results: It was found that patients with a lower anti-PLA2R antibody level had higher spontaneous remission rates compared to those at high levels. Specifically, 80% of patients with low anti-PLA2R levels reached remission after receiving conservative therapy, which was much higher compared to 33% of those with high levels. Among the patients who received immunosuppressive therapy, 83.3% of those with low anti-PLA2R levels reached remission compared with 27.3% of those with high anti-PLA2R levels. These results indicate that the anti-PLA2R antibody level is a strong predictor of treatment response and disease outcome. Conclusion: Anti-PLA2R antibody levels are a useful biomarker for predicting the clinical outcome of primary membranous nephropathy. Low levels of anti-PLA2R antibodies could indicate better responsiveness to both conservative and immunosuppressive treatments. Anti-PLA2R antibodies, if incorporated into routine practice, may promote individually tailored treatment decisions and strategies for the optimization of management.

Background: HPV infection attributed cancers are more common among women in low- and middle-income countries, while men are more commonly affected in high-income countries. There is a gap in knowledge about HPV infection, HPV vaccine and preventive strategies among the health care providers which will determine the future trends of HPV infection in India. Hence, this study was conducted with the aim of assessing the level of knowledge regarding HPV infection and the role HPV vaccine as a preventive strategy among the medical students. Materials & Methods: Between January 2018 and March 2018, data were collected using a pre-structured questionnaire, approved by the ethics committee that was distributed through an online web portal. Responses were stored in a cloud-based format on Qualtrics, and analyzed in SPSS. All participants completed informed consent prior completion of the survey. Results: of the 498 participants who completed the survey, 114 (22.9%) were in pre-clinical, 151 (30.3%) in preclinical and 233(46.8%) were in clinical stage of their medical training. The level of knowledge among medical students increased with the number of years spent in medical school across all domains (p < 0.0001). However, in key areas crucial to understanding the transmission of HPV and its impact on disease prognosis, students demonstrated poor knowledge. Of the female students, only 7.5% (17) had been vaccinated against HPV. Conclusion: The knowledge gap among future healthcare providers significantly hinders the effective implementation of preventive strategies. It is essential to take comprehensive measures, addressing everything from policy-making to raising awareness among high-risk populations, and equipping healthcare providers with the necessary training and knowledge to achieve the WHO cervical cancer elimination goal by 2030.

Aim: This study aims to check the pulmonary functions of healthy working women exposed to inhaled chemicals in hospital laboratories and to compare that with the non-exposed healthy women. Materials and Methods: The study was carried out in 50 healthy working women in the age group of 20-40 years who are working in hospital chemical laboratories and in other 50 healthy working women of same age group who are working in the administrative section. Volunteers were selected on basis of inclusion criteria. The volunteers were chosen in both case as well as control group in order to minimize the confounding factors and make the study reproducible. Informed written consent was obtained from all the volunteers before testing. Volunteers were explained in detail about the test procedure and a diagram was shown for the better understanding of the tests. Result: In females exposed to laboratory chemicals as compared to the unexposed, all parameters were significantly reduced. FVC, FEV1 & FVC/FEV1 were significantly reduced in exposed as compared to unexposed indicating that the lung volume, flow and resistive properties of the bronchopulmonary tree were affected. The difference was also significant for static lung function tests as TV, IRV and SVC in exposed females and indicated that lung volume was affected along with lung elasticity and mobility. Significantly decreased PEFR and FEF 25-75 in the exposed group indicated that upper as well as small airways might be affected due to exposure to lab chemicals. Lung age was more than chronological age in both the groups but the gap was huge for exposed females. The difference in lung age in exposed and non-exposed females was highly significant and pointed towards the decreased function. No single chemical was found to lead to the cause rather it was the cumulative effect of multiple chemicals and reagents used in the laboratory. We found out that inhaled chemical exposure during hospital laboratory work resulted in detrimental effects on static lung volumes as well as flow rates amongst the exposed group. Conclusion: This study concluded that risk factors for respiratory dysfunction significantly increase in females who are exposed to laboratory chemicals. Thus, there is a need for regular pulmonary function testing and taking preventive measures to avoid chemical exposure in laboratory workers.

Background: The gut microbiota plays a crucial role in maintaining metabolic health, with imbalances in microbial composition increasingly linked to metabolic disorders such as type 2 diabetes, obesity, dyslipidemia, and metabolic syndrome. However, the prevalence and specific associations between microbiota profiles and these disorders remain inadequately explored. Methods: A 100-person cross-sectional study was conducted from March 2023 to July 2024. Stool sample analysis and next-generation sequencing examined microbiota composition, while clinical evaluations and blood testing detected metabolic abnormalities. We used statistical analysis to estimate metabolic disorder prevalence and microbiome profile correlations. Results: Substantial correlations between metabolic diseases and intestinal microbiota patterns were identified in the cross-sectional study of 100 individuals. Obesity was 35%, type 2 diabetes 22%, dyslipidaemia 28%, and metabolic syndrome 18%. Participants with greater Firmicutes/Bacteroidetes ratio had a 1.5-fold increased risk of obesity (95% CI: 1.2-1.8, p < 0.01), while raised Proteobacteria levels increased type 2 diabetes risk by 2.3-fold (95% CI: 1.7-3.0, p < 0.01). Lower microbial diversity was related with 1.8 times greater risks of dyslipidaemia (95% CI: 1.4–2.4, p < 0.01). Prevotella abundance was also linked to a 40% decreased metabolic syndrome risk (95% CI: 0.5–0.8, p = 0.04). These findings recommend microbiota-based markers may help diagnose and treat metabolic diseases. Conclusion: The study highlights the potential of microbiota-based biomarkers in the early detection and management of metabolic disorders. It underscores the need for further longitudinal research to establish causality and explore microbiota-modulating interventions for improving metabolic outcomes.

Background: Intraocular pressure (IOP) is a crucial factor in the development of glaucoma and other eye conditions, with various physiological, environmental, and systemic factors influencing it. Anxiety, through the activation of the body’s stress response, has been linked to elevated IOP, potentially contributing to ocular pathologies such as glaucoma. This study aims to evaluate the impact of anxiety severity and symptom duration on IOP in patients diagnosed with chronic anxiety. Methods: A cross-sectional, observational study was conducted on 72 patients with chronic anxiety attending the Psychiatry OPD. Anxiety severity was assessed using the Hamilton Anxiety Rating Scale, categorizing patients into mild, moderate, and severe anxiety groups. IOP was measured using a Goldmann Applanation Tonometer, and the results were statistically analyzed to determine the relationship between anxiety severity, symptom duration, and IOP. Results: The study found that IOP was highest in the severe anxiety group (17.90 ± 2.20 mm Hg) and lowest in the mild anxiety group (14.42 ± 1.85 mm Hg). Duration of symptoms influenced IOP, with the highest IOP recorded in the 3-6 months duration group for severe anxiety and the >12 months group for mild anxiety. Statistically significant differences were observed between the severe and mild anxiety groups (p < 0.05). Conclusion: The study indicates that increased severity of anxiety is associated with higher IOP, and the duration of symptoms also influences these levels. Chronic anxiety could contribute to increase IOP, potentially heightening the risk for glaucoma and other ocular conditions. Routine glaucoma screening is recommended for chronic anxiety patients.

Introduction & Objective: Most maternal and infant deaths occur in first 42 days after childbirth.² Proper utilization of postnatal care services plays an important role in reducing the maternal mortality rate. The objective of the study was to assess the utilization of the postnatal services provided to mothers and associated factors. Materials and Methods: A community based, cross sectional study using multistage sampling methodology was carried out from 1st May, 2016 to 30th April, 2017, in Southern Odisha. Married women with 6 weeks to 6 months old baby were included in the study. Results: 85.5% of women received postnatal visit by the health personnel within 42 days of delivery. The main reason for non-utilization was no-one visited their house and unawareness about the PNC. The factors associated with low utilization were education, socio economic status and parity of mother, frequency of ANC and place of delivery. Conclusion: The study highlighted gap in the post-natal services received by the mother which could be strengthened by counselling to all mothers attending the VHND Sessions and involvement of the family members.

Background: Hypertension in pregnancy is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Objective: to find out whether the lateral location of placenta as seen by ultrasound at 18-24 weeks of gestation can be used to predict the development of preeclampsia. Methods: This Prospective study was conducted among 100 pregnant women of 18-24 weeks of gestational age attending the outpatient department for antenatal care at government maternity hospital, Hanamkonda during the period of November 2019 to October 2021. Result: Out of the 100, 50 had lateral placenta of which 21 developed preeclampsia and 50 had central placenta of which 10 developed preeclampsia. None of the patients were diagnosed with gestational hypertension. Of the total 31 patients with preeclampsia, 3 had urine albumin trace, 15 had urine albumin of 1+ and 13 had urine albumin of 2+ Majority of the preeclampsia was diagnosed preterm between 32-36+6 weeks period of gestation. Of the 31 preeclampsia patients 17(55%) are P1, 8(25%) are primigravida, 4(13%) are P2 and 2(7%) are P3. Of the 31 preeclampsia patients 19(61%) underwent LSCS and 12(39%) underwent vaginal delivery but the overall incidence of vaginal delivery is 74% and LSCS being only 26% among 100 patients. Conclusion: Our study shows correlation between lateral placenta and preeclampsia, many previous studies have shown a positive correlation and hence a strict vigilance and follow up of these patients needed for earlier identification and diagnosis of preeclampsia and to prevent the complications for fetus and mother.

Introduction: Radiology plays a crucial role in modern healthcare, aiding in diagnosis, treatment planning, and disease monitoring. Despite technological advancements in imaging modalities such as CT, MRI, and ultrasound, errors in radiological image interpretations and reportings remain a significant concern. These errors, categorized into perceptual and interpretative types, can result in delayed diagnoses and inappropriate treatments, highlighting the need for strategies to minimize such mistakes. Materials and Methods: This cross-sectional study, conducted over six months at a tertiary care hospital, included 100 radiological cases with confirmed errors identified through multidisciplinary meetings and retrospective chart audits. Errors were categorized by imaging modality (CT, MRI, ultrasound, plain radiography) . Descriptive statistics and logistic regression analyses were used to analyze error frequencies and contributing factors. Results: CT scans accounted for 40% of errors, followed by MRI (30%), ultrasound (20%), and plain radiography (10%). Perceptual errors were more common (60%) and linked to fatigue, subtle findings, and inadequate training, while interpretative errors (40%) were associated with cognitive biases and insufficient clinical data. Discussion: Perceptual errors were the most frequent, primarily due to fatigue and missed subtle findings. Interpretative errors, though less frequent, had a greater impact on patient management and were often influenced by cognitive biases. AI tools have potential to assist in reducing these errors, but must complement human expertise. Effective communication and structured reporting between radiologists and referring physicians were also found to be essential in minimizing errors. Conclusions: Errors in radiological interpretation remain prevalent, with perceptual errors being more common. Addressing these challenges through technological advancements, improved training, and enhanced communication between healthcare providers can lead to more accurate and reliable radiological reporting.

Background: Endodontic treatment often leaves teeth weakened, necessitating prosthodontic restorations to restore function and aesthetics. While advancements in dental materials and technology have enhanced the aesthetic potential of such restorations, understanding patient satisfaction remains critical for improving care. Objective: To evaluate patient satisfaction with the aesthetic outcomes of prosthodontic restorations on endodontically treated teeth, considering factors such as gender, age, and restoration type. Materials and Methods: A cross-sectional study involving 200 patients aged 18–70 years was conducted at a tertiary dental care center. Patient satisfaction was assessed across four aesthetic domains—shade matching, translucency, shape, and overall appearance—using a 5-point Likert scale. Clinical data on restoration type and material were correlated with satisfaction scores. Results: The mean satisfaction score was 4.5 (SD ±0.4). Female patients and those aged 18–35 years reported higher satisfaction. Shade matching and overall appearance were the highest-rated domains. Statistical analysis revealed significant correlations between demographic factors and satisfaction scores. Discussion: Findings highlight the importance of patient-centered approaches in prosthodontics, emphasizing the role of advanced materials and effective clinician-patient communication. Challenges in achieving translucency suggest areas for further innovation. Conclusions: Prosthodontic restorations achieve high aesthetic satisfaction, with significant influences from age, gender, and material selection. Advances in material science and patient-centered care can further enhance outcomes.

The primary goal of this article is to emphasize the critical role of emergency coronary artery bypass surgery in cases involving entrapped stents and guidewires. We present two cases in which surgical intervention was required due to guidewire entrapment, necessitating both rescue and revascularization. In one case, the procedure involved the use of cardiopulmonary bypass, with the heart arrested and the aorta opened, and followed by revascularization. In contrast, the second case was managed off-pump, involving removal and revascularization without the need for cardiopulmonary bypass.

Background: Surgical management of pediatric abdominal conditions such as intussusception, volvulus, and pyloric stenosis has evolved significantly with the increasing adoption of laparoscopic techniques. Minimally invasive surgery (MIS) is associated with improved outcomes, but open surgery remains the preferred approach in certain complex cases, particularly emergencies like volvulus. Objective: This study aims to evaluate the trends in the use of laparoscopic versus open surgery in the treatment of intussusception, volvulus, and pyloric stenosis, comparing patient outcomes in terms of operative time, hospital stay, and postoperative complications. Materials and Methods: A retrospective analysis was conducted with a sample size of 330 pediatric patients who underwent surgery for intussusception (n=150), volvulus (n=80), and pyloric stenosis (n=100). Each group was subdivided based on the surgical approach: open or laparoscopic. Patient outcomes such as operative time, length of hospital stay, and complications were analyzed and compared between the two approaches. Results: Laparoscopic surgery was predominantly used for intussusception (80%) and pyloric stenosis (20%), while open surgery was more common for volvulus (70%). Laparoscopic procedures resulted in shorter operative times (75 vs. 85 minutes, p=0.02), reduced hospital stays (3.1 vs. 5.2 days, p<0.001), and fewer complications (10.3% vs. 18.7%, p=0.04) compared to open surgery. Conclusion: Laparoscopic surgery offers significant advantages in the management of intussusception and pyloric stenosis, including shorter hospital stays and fewer complications. However, open surgery remains the preferred approach for volvulus due to its technical complexity and emergency nature.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women. It is associated with metabolic abnormalities such as obesity, insulin resistance, and thyroid dysfunction. This study aims to evaluate the correlation between body mass index (BMI), thyroid-stimulating hormone (TSH) levels, and glycated hemoglobin (HbA1c) among women females  diagnosed with PCOS aged between 18 – 50 yrs. Menstrual irregularities and infertility are more prevalent in obese PCOS women. Obesity is also closely associated with PCOS, which affects 6–12% of women of reproductive age. A cross-sectional study was conducted involving 100 women aged 18 – 50 yrs diagnosed with PCOS based on  Rotterdam criteria. Data on BMI, TSH levels, and HbA1c were collected and analyzed to assess correlations using SPSS paired t- test, 2-tailed spearman correlation. In present study, it was found that TSH has positive correlation with BMI( r=0.3, p=0.002). HbA1C has positive correlation with BMI ( r=0.266, p=0.007). TSH has a positive correlation with HbA1C (r=0.29, p=0.003). In conclusion this study shows the significant correlation between BMI, TSH levels and HbA1c among diagnosed PCOS females. These correlations emphasize the need for integrated management strategies targeting obesity, thyroid dysfunction, and insulin resistance to improve metabolic outcomes in this population.

Background: Vitamin B12 deficiency during pregnancy has been associated with various adverse pregnancy outcomes, including preterm birth. This study aimed to investigate the prevalence of vitamin B12 deficiency in early pregnancy and its association with preterm birth among pregnant women attending a tertiary hospital in India. Methods: This prospective cross-sectional study included 236 pregnant women between 14 and 20 weeks of gestation. Serum vitamin B12 levels were measured using the Electro Chemi-Luminescence-Immuno-Assay method, with deficiency defined as levels <200 pg/ml. Gestational age at delivery was recorded, and preterm birth was defined as delivery before 37 completed weeks of gestation. The association between vitamin B12 deficiency and preterm birth was analyzed using the chi-square test. Results: The mean serum vitamin B12 level was 231.0556 pg/ml (SD 104.2277), with 32.63% of the participants being deficient. The prevalence of preterm birth was 15.25%. A significant association was found between vitamin B12 deficiency and preterm birth (p=0.015732), with 50% of the women who had preterm deliveries being deficient in vitamin B12, compared to 29.50% of the women who had term deliveries. Conclusion: This study found a high prevalence of vitamin B12 deficiency in early pregnancy and a significant association between vitamin B12 deficiency and preterm birth among pregnant women in India. The findings highlight the importance of screening for vitamin B12 deficiency in early pregnancy and the need for interventions to improve vitamin B12 status among pregnant women, particularly in developing countries.

Background: Dengue fever is caused by dengue virus of Flaviviridae family which is transmitted by Aedes aegypti mosquito. Dengue haemorrhagic fever  (DHF) clinically presenting as epistaxis, oral/gum bleeding. Thrombocytopenia may be linked to DHF illnesses, with risks that can vary from severe bleeding or blood clotting to no risk at all. Thrombocytopenia is characterised by a platelet count that falls below the lower threshold of the normal range. The present study was carried out on 17 DHF with Epistaxis patients to established clinical profiling/ management of epistaxis in dengue haemorrhagic fever. Materials and Methods: This prospective study was conducted at Tertiary Care Centre (HIMS), Ataria, Sitapur, UP from June 2021 – August 2021.Complete blood count including differential blood count, packed cell volume (PCV) and absolute platelet count (APC), PT/INR with NS1 card test were done. PCV and APC were monitored serially, at least once a day and if necessary more frequent intervals. Renal functions and liver enzymes were done routinely for all patients by using an auto-analyser. Ultrasonography of abdomen and radiograph chest was done by an experienced sonologist and radiograph chest were done for all patients. Fluid management of patient was according to WHO guidelines. Results: A total of 17 dengue haemorrhagic fever (NS1 positive) with epistaxis cases were studied. Out of 17 cases, 14 cases were male (82.35%) and 3 cases were female (17.65%). Male: female was 4.67, aged 18-70 years, and mean age was 40 years. The mean and median patient ages were 40 and 35 years, respectively (95% confidence interval [95% CI]: 35.3-41.2 years). Platelet count range 12k to 150k with mean of 30.76k. Mean platelet count among patients with epistaxis those were not required nasal packing (9 Cases) was 44k and subsequently mean platelet count of those were required nasal packing (8 cases) was 22.25k. It was Observed, Hb range from 8.6 gm/dl to 14.7 gm/dl with mean of 11.24 gm/dl. Pt/INR was also observed, range from 13.67 Sec to 14.13 Sec with mean of 13.81 Seconds. Transfusion was required in 6 cases (35.3%) and subsequently non required cases were 11 (64.7%).The mean platelet count upon hospital discharge was 111.2 × 109/L (95% CI: 97.8-124.7 × 109/L). The mean lowest leukocyte count was 4.6 × 109/L (95% CI: 3.8-5.3 × 109/L), with a minimum value of 0.7 x 109/L and a maximum value of 57.0 × 109/L. Plasma leakage was observed in 100% of the cases (95% CI: 99.9) and hypotension and hemodynamic instability occurred in 89.9.0% and 99.87% of these cases respectively. Regarding the CBC, anemia was observed in 68.0% of the cases (95% CI: 77.8-89.4), and the mean lowest hemoglobin level of all patients who received any type of transfusion during hospitalization was 8.6 g/dL. Conclusion: The present study was carried out in 17 patients with DHF-Epistaxis, so far it was done in a large samples as compared to reported case studies on DHF-Epistaxis. Hence, our results, on thrombocytopenia, platelet counts, Haematocrit levels, HB values, transaminase levels Lymphocyte counts, transfusions, and Nasal Packing etc could be considered as a land mark cut-off for the treatment and management of Dengue Hemorrhagic Fever with Epistaxis.

Objectives: Microorganisms can be transmitted from animated resources to inanimate environmental assets. They can also emerge as secondary reservoirs if they meet transmitted pathogens as they needs to live and multiply. In the present study aim Role of fomites in the health care associated infections in tertiary care hospitals. Methods: A retrospective cross-sectional study was performed among 100 sample were randomly collected between June – July, 2022from, Katuri Medical College Guntur. We were taken the sample from the Mobile, stethoscope, pen, watch, apron and key chain of health care workers such as Doctors, Pg students, intern and nurses at high-risk area like ICCU, MICU, SCIU and NICU. These fomites are the most frequently used and contaminated easily with fingers. Rolling over the exposed surfaces of each fomite and using sterile swabs soaked with sterile 0.9% NaCl allowed samples to be collected aseptically. Results: Majority of bacteria isolated from HCW’s mobile phones were Methicillin resistant Staphylococcus aureus (30.7%).23% of the pseudomonas aeruginosa isolated from HCW’s mobile phones.2.5% clostridium spp were identified on mobiles phone of HCW’s. Conclusions: Necessitate for educating the patients and their attendees about the risk of hospital acquired infections and self-measures required to be taken by them. Monitor the screening of the hospital and its environment for the pathogenic bacteria presence.

Background: Colorectal adenocarcinoma is a major cause of cancer-related mortality worldwide, necessitating detailed histopathological evaluation for accurate staging and management. This case series aims to elucidate the clinicopathological features of colon adenocarcinoma in surgically resected specimens, highlighting variations in tumour site, histopathology, and staging. Methods: This prospective case series analysed eight adult patients who underwent surgical resection for colorectal adenocarcinoma at Department of Pathology, ICARE Institute of Medical Sciences and Research, Haldia. Data were collected on patient demographics, surgical procedure type, tumour location, histopathological diagnosis, tumour grade, and TNM staging. Results: The patients ranged from 31 to 87 years old, with a male predominance. Histopathological examination revealed mostly moderately differentiated adenocarcinoma. Staging varied from Stage IIA to IVB. Conclusions: The findings demonstrate the predominance of moderately differentiated adenocarcinoma in various segments of the colon and rectum, often diagnosed at advanced stages. This underscores the importance of early detection and comprehensive histopathological evaluation to improve prognostic outcomes. Future studies with larger cohorts are needed to further explore the correlations between histopathological characteristics and clinical outcomes in colorectal adenocarcinoma.

Introduction: Fluid cytology plays a pivotal role delineating benign from malignant effusions, tumor staging and diagnosing recurrences. Objectives are (1) To assess Risk of Malignancy of The International System for Reporting Serous Fluid Cytopathology on cytospin smears. (2) To assess the Diagnostic Utility of Cytospin Preparations with Cell Block method. Material and Methods: This was a retrospective study done during the period of 12 months (July 2023 to June 2024) in the department of Pathology, ESIC Medical College and Hospital, Kalaburagi, Karnataka. Serous fluids (pleural and peritoneal fluids) were received and analysed by cytospin smears and cell block preparation, following conventional smear cytology. Cytospin preparations were reported using The International System for Reporting Serous Fluid Cytopathology (ISRSFC). Cell block preparations were taken as gold standard. Results: Of the 461 samples studied during the study period, using the ISRSFC on cytospin smears, 8 cases (1.73%) were categorised as Non-Diagnostic (ND), 437 cases (94.79%) as Negative for Malignancy (NFM), 4 cases (0.86%) as Atypia of Unknown Significance (AUS), 03 cases (0.65%) as Suspicious for Malignancy (SFM) and 09 cases (1.95%) as Malignant (MAL). 145 cell blocks were prepared, of which 139 cases were available for cytospin vs. cell block correlation. Risk of malignancy of The International System for Reporting Serous Fluid Cytopathology (ISRSFC) on cytospin smears were 0% for ND, 0.86% for NFM, 25% for AUS, 66% for SFM and 100% for MAL. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of cytospin preparations with cell block method were 92.85 %, 100 %, 100 %, 99.2 % and 98.5 % respectively. Conclusion: Risk of Malignancy on cytospin smears using The International System for Reporting Serous Fluid Cytopathology (ISRSFC) exhibits high accuracy values for serous effusion cytology. The utility of cytospin smears in comparison to cell block in delineating malignant effusion from the non-malignant effusion were similar.

Background: Essential hypertension is a prevalent condition globally and a leading cause of morbidity due to its association with cardiovascular and renal complications. Early detection of renal impairment in hypertensive patients is crucial to prevent progression to chronic kidney disease (CKD). Serum creatinine and urine microalbumin are widely used markers for assessing renal function and detecting early renal damage. Aim: This study aimed to evaluate serum creatinine and urine microalbumin levels in patients with essential hypertension and to explore their correlation with disease duration and severity. Methods: A cross-sectional study was conducted over 12 months at the VSS Institute of Medical Sciences and Research, Burla, Odisha, involving 200 hypertensive patients. Participants’ demographic and clinical data were collected. Serum creatinine levels were measured using the modified Jaffe method, while urine microalbumin levels were assessed using an immunoturbidimetric method. Statistical analyses were performed using SPSS version 23.0, with Pearson’s correlation and t-tests applied to identify associations between variables. Results: The mean serum creatinine and urine microalbumin levels were 1.15 ± 0.29 mg/dL and 48.6 ± 22.4 mg/L, respectively. Elevated serum creatinine levels were observed in 21% of participants, while 40% had elevated urine microalbumin levels. A significant positive correlation was found between serum creatinine and urine microalbumin levels (r = 0.51, p < 0.001). Participants with a longer duration of hypertension (>5 years) exhibited significantly higher levels of both markers (p < 0.05). Conclusion: A considerable proportion of hypertensive patients exhibited elevated serum creatinine and urine microalbumin levels, indicating early renal impairment. The strong correlation between these markers emphasizes their utility in detecting renal dysfunction at an early stage. Recommendations: Routine monitoring of serum creatinine and urine microalbumin levels should be incorporated into the management of hypertensive patients to enable early detection and intervention. Further longitudinal studies are recommended to assess the progression of renal damage and evaluate the impact of targeted therapeutic measures.

Background: Retinopathy is a complication of chronic diabetes mellitus and other systemic diseases. This often impacts the patient’s mental health, especially in newly diagnosed conditions. Depression and anxiety are commonly prevalent among these individuals due to the threat of loss of vision, disease burden, and reduced quality of life. We undertook this study to understand the prevalence and associated factors for developing psychological conditions. Methods: This study included patients newly diagnosed with various retinopathies. The diagnosis of retinopathy was done using an ophthalmoscope. The validated [Hospital Anxiety and Depression Scale (HADS), and Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety] were used to assess symptoms of depression and anxiety. These are widely used and validated self-report measures.  Other Relevant Factors: Questions related to social support, coping mechanisms, perceived impact of retinopathy on daily life, and access to healthcare services. Results: The study included 100 participants (62 males, 38 females; mean age: males 62.55 ± 5.3, females 61.25 ± 8.54 years). Retinopathy prevalence increased with age, with the 61–70 age group most affected. Socioeconomic analysis revealed higher prevalence in lower socioeconomic classes. Diabetic retinopathy (44%) was most common, followed by hypertensive retinopathy and age-related macular degeneration (AMD). Anxiety and depression levels, assessed via HADS and GAD-7 scales, showed moderate/severe anxiety in 33% of hypertensive retinopathy cases and 29% of diabetic retinopathy cases. Depression was moderate/severe in 14–17% of these groups. AMD cases exhibited milder anxiety and depression symptoms. Conclusion: In conclusion, this study highlights a significant prevalence of anxiety and depression among patients with various retinopathies, particularly diabetic and hypertensive retinopathy. Diabetic retinopathy was the most common, followed by hypertensive retinopathy, with cases predominantly in older age groups and lower socioeconomic classes. Moderate to severe anxiety was observed in 29–33% of diabetic and hypertensive retinopathy patients, while 14–17% exhibited moderate to severe depression.

Background: Nausea and vomiting following Regional Anaesthesia in pregnant women undergoing Caesarean section is a major clinical problem. The present study was undertaken to compare the safety, efficacy and anti-emetic effect of Ondansetron and Metoclopramide in prevention of Post operative Nausea and Vomiting in LSCS under Spinal Anaesthesia. Material and Methods: After obtaining the approval of institutional ethical committee permission, a prospective randomized observational study was conducted on 50 women patients aged above 18 years of ASA I or II Grade undergoing elective LSCS under Spinal anaesthesia. They were assigned randomly into two groups of 25 each. Group-O received Inj. Ondansetron 4mg I.V. and Group- M received Inj. Metaclopramide 10 mg I.V.  ten minutes before Spinal Anaesthesia. Anaesthetic management was standardized. Incidence of post operative vomiting and retching as number of episodes was studied, Nausea was graded depending on the severity and need of rescue anti-emetic was recorded in all patients for 24 hours post operatively and the safety, efficacy and anti-emetic effect of Ondansetron to Metaclopramide in the prevention of post operative nausea and vomiting was evaluated. Results: The mean age, weight and ASA grading was not significantly different when compared Group- O parturiants with Group M. Number of episodes of Nausea ,Retching and Vomiting were recorded at time intervals of 0 hour, 1 hour,2 hour,4 hour,6 hour,8 hour,12 hour and 12 hour for all the patients in both groups .Incidence of  Nausea was more in Group- M than Group- O at 0 hour, 1 hour and 2 hour, but was statistically significant (p<0.05) at 2 hour only. Incidence of Retching was more in the 0 hour, 1 hour and 2 hours in Group- M and incidence of retching was reduced significantly in Group -O patients at 2 hours. Incidence of Vomiting was decreased in Group -O than Group- M, but was not statistically significant. It was found that Inj. Ondansetron was more efficient than Inj. Metaclopramide in preventing Post-operative Nausea and Vomiting in patients undergoing LSCS under Spinal Anaesthesia. Conclusion: The study concluded that the safety, efficacy and anti-emetic effect of Injection Ondansetron is more than Injection Metaclopramide in the prevention of Post-operative Nausea and Vomiting in Patients undergoing LSCS under Spinal Anaesthesia.

Background: Schizophrenia, a complex and chronic mental health disorder, characterized by disturbances in thought, perception and behavior. Insight in schizophrenia is critical in influencing the prognosis and management of the disease. Aim: To study the level of insight in patients with schizophrenia. Materials and Methods: 40schizophrenia patients who met inclusion criteria were included for the study. Study was conducted for a period of 18 months. ICD-10 diagnostic criteria, BPRS for assessing symptom severity, and SUMD (scale for assessment of unawareness in mental disorders) to assess the level of insight were used for the current study. Results: Mean age of patients was 36.9 years, mean insight scores of all items of SUMD showed statistically significant improvement in insight scores at 4weeks follow up. On comparing the insight and severity of psychotic symptoms we found a positive correlation between 1c, 1p,2c,2p items of SUMD and BPRS. No statistical significance was established on comparing the duration of illness and insight in schizophrenia. Conclusion: the study concluded that insight improves with treatment and poor insight is associated with severe psychotic symptoms.

Introduction: Neonatal hyperbilirubinemia (NNH) is an ongoing problem that requires medical attention and hospital readmission in newborns. Approximately 5-10 percent of all newborns require intervention for pathologic jaundice. Exchange Transfusion (ET) is an effective emergency intervention to lower the S. bilirubin (SBR) levels in neonates at high risk of bilirubin encephalopathy. Aim: To evaluate the efficacy of whole blood and whole blood reconstituted used in Exchange transfusion in NNH due to HDFN (hemolytic disease of newborn). Materials and Methods: 40 neonates with ABO and Rh (Rhesus) Hemolytic Disease of Fetus and newborn were included in this study and ET was done in both groups either using Whole Blood (WB) or Whole Blood Reconstituted (WBR) being selected by randomization. Results: In the present study, the efficacy of exchange transfusion between whole blood and whole blood reconstituted among 20 cases of NNH with ABO HDFN revealed improvement in haemoglobin and fall in SBR level was evident in 7 out of 14 cases with WB and in all 8 cases of ABO HDFN with WBR. Improvement in haemoglobin level and a fall in SBR were observed in both groups of Rh HDFN. Conclusion: In cases of ABO HDFN, better outcome happened with whole blood reconstituted than whole blood alone for exchange transfusion to bring back desired level of Hb and SBR. In cases of Rh HDFN, no difference was observed between WBR and WB groups. However, to avoid failure in achieving the desired results with ET, in cases of ABO HDFN using O Whole blood, it is essential to use “O Whole Blood” with antibody titre less than the critical level. Further, to avoid unexpected exposure to anti-D in cases of Rh HDFN WBR exchange transfusion, it is necessary to use AB plasma only from male donors without the history of prior transfusion.

Background: The use of laparoscopy has gained widespread popularity in surgical approaches to abdominal wall hernias and intestinal and solid organ resection. However, no other operation has been as profoundly affected by the advent of laparoscopy as cholecystectomy. To evaluate the feasibility and safety of the minilap cholecystectomy (MLC) and to compare the clinical benefits experienced by patients who undergo MLC with those who undergo laparoscopic cholecystectomy (LC). Materials & Methods: From July 2010 to September 2011 patients were recruited at Surgery OPD of a tertiary care teaching Hospital, Kolkata, into this prospective randomized control trial. Eligible patients must have experienced at least one attack of typical biliary colic, associated with nausea and vomiting, have USG proven cholelithiasis, in the age group of l0- 69 years and presented for elective cholecystectomy. Results: Mean age in the LC group is 37.22±11.37 years (range 11-69 years) and MC group 38.54±11.62 years (range 10-63 years). Mean OT time for MLC was 54.84 mins versus 63.92 mins for the LC group. Median values for LC were also longer 75 mins vs 48.33 mins. Modal values are 75.5 and 45.5 mins for LC and MLC groups respectively. Three out of 50 cases of LC ended in conversion giving an overall conversion rate of 4 out of 50 cases of MLC resulted in conversion to standard open cholecystectomies by extension of incision; i.e. a conversion rate of 7%. The observed difference is however, not statistically significant, (p>0.05). Overall complications rates were 6% for LC’s and 8% for MLC’s (not significant, p>0.5) and was comparable to the morbidity of the most series of LC’s and MLC’s. Time for full ambulation for LC patients was on an average 22.56±6.70 hrs vs 26.30±5.809 hrs for MLC patients (significant p<0.5), I.e. almost 5 hrs ahead of the MLC patients. Conclusion: Minilap cholecystectomy has been found to be safe with several advantages in terms of time, cosmesis, and post-operative morbidity and wound pain shortened hospital stay leading to cost benefit. Mini-laparotomy cholecystectomy is an alternative to laparoscopic approach in the surgical treatment of acute and chronic cholecystitis.

Background: Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by insulin resistance and chronic inflammation. The most prevalent kind of diabetes is Type 2 Diabetes, or non-insulin dependent diabetes mellitus (NIDDM). Non-insulin dependent diabetes mellitus (NIDDM) accounts for more than 90% of diabetes and typically features insulin resistance or insulin secretory defects. Objectives: In this study, we aimed to assess serum insulin, insulin resistance and inflammatory markers in T2DM patients and healthy controls. And also investigate the relationship between insulin resistance and inflammatory markers in T2DM patients. Materials and Methods: A total number of 100 patients were included in the hospital based analytical cross–sectional study. This includes 50 subjects of NIDDM and 50 healthy control of age group of 20 to 65 years. After an overnight fast of 10-12 hours, venous blood sample was drawn from anticubital vein of each subject by using standard aseptic techniques. Serum was separated by centrifugation and used for the following biochemical analysis. Serum Insulin and inflammatory markers (CRP, IL-6, serum ferritin) was estimated using Fully Automatic Analyzer and Insulin Resistance was calculated using HOMA-IR. Statistical analysis was analyzed using Student’s t-test. Results: There is highly significant increase in the levels of serum insulin, serum insulin resistance index, serum ferritin, CRP and IL-6 in subjects of NIDDM as compared to healthy controls (p < 0.0001). Conclusion: Our study revealed hyperglycemia, hyperinsulinemia, and dyslipidemia in non-insulin dependent diabetes mellitus (NIDDM) subjects and inflammatory markers are also high due to low grade inflammation. These findings have implications for understanding the pathophysiology of T2DM and developing therapeutic strategies to target insulin resistance and inflammation.

Background: Echinococcosis, or hydatid disease, is caused by the larval forms of taeniid cestodes belonging to the genus Echinococcus. Echinococcus granulosus and E. multilocularis are the primary species responsible for human echinococcosis, and mostly they affect the liver. The disease course is typically slow, and the patients tend to remain asymptomatic for many years. Case presentation: A 8 year old male child with Right upper quadrant pain & swelling since 6 months. USG whole abdomen shows multiple septated cystic lesions (honeycomb) within hepatic segment VI, VII & II), CE2. The CT scan shows Smooth SOL with several septations. Echinococcal IgG raised. Preoperatively 3 cycles of tab Albendazole, 2 wks each given. Partial cystopericystectomy done in both lobes. Post op uneventful, discharged after 3 days. Conclusions: Hydatid disease in the liver may persist without symptoms and often goes undiagnosed due to the slow growth of the cysts. The diagnosis needs careful history reporting, physical examination, and appropriate imaging investigations.

Background: Diabetes mellitus (DM) significantly increases the risk of coronary artery disease (CAD) due to metabolic and vascular dysfunction. Objective: This study aimed to compare the clinical, echocardiographic, lipid, and angiographic profiles of diabetic and non-diabetic CAD patients. Methods: A cross-sectional study was conducted in a tertiary care center, including adult CAD patients. Participants were categorized into diabetics (Group A) and non-diabetics (Group B). Data on clinical presentation, lipid profiles, ECHO findings, and angiographic patterns were collected. Results: The mean age of Group A was 55.63 years, and Group B was 55.33 years, with no significant difference (p = 0.748). Group B had a significantly higher proportion of males (80.0%) compared to Group A (71.2%) (p = 0.036). AWMI was the most common presentation in both groups, followed by IWMI with no significant differences in clinical presentations (p = 0.257). Lipid profiles revealed significantly higher triglycerides (median: 151 vs. 125 mg/dL) and LDL (median: 86 vs. 56 mg/dL) and lower HDL (median: 43 vs. 64.5 mg/dL) in group A (p < 0.0001) compared to group B. Angiographically, Group A had more double-vessel (27.4%) and triple-vessel disease (16.4%), while Group B had more single-vessel disease (72.5%) (p = 0.001). ECHO findings were similar between groups (p = 0.810). Conclusion: Diabetic patients demonstrated more severe coronary artery disease, worse lipid profiles, and a higher prevalence of AWMI compared to non-diabetic patients. These findings emphasize the need for targeted prevention and management strategies.

Background: Supraclavicular brachial plexus block is a widely used technique for upper limb surgeries. This study compares the efficacy and safety of the conventional technique versus the ultrasound-guided technique. Methods: A randomized, single-blinded, prospective study was conducted on 60 patients, aged 18–60 years, classified as ASA I or II, undergoing elective upper limb surgeries. Patients were divided into two groups: Group C (conventional technique) and Group US (ultrasound-guided technique). Demographic data, procedural time, onset and duration of sensory and motor blockades, intraoperative analgesic requirements, block effectiveness, and complications were analyzed. Statistical significance was assessed using appropriate tests, with a p-value < 0.05 considered significant. Results: Demographic characteristics were comparable between groups. The time to perform the block was shorter in Group C (6.1 ± 2.1 min) than in Group US (9.1 ± 3.2 min) (p < 0.01). Onset of sensory (9.1 ± 3.1 min) and motor blockade (9.9 ± 4.9 min) was faster in Group US (p = 0.002, p = 0.02, respectively). Group US also exhibited longer sensory (6.9 ± 1.1 hrs) and motor block durations (6.9 ± 0.9 hrs) compared to Group C (4.5 ± 2.3 hrs and 6.1 ± 2.1 hrs, respectively) (p < 0.05). Intraoperative analgesic requirements and complication rates were significantly lower in Group US (p < 0.05). The success rate was higher in Group US (100% vs. 93.1%), with no cases requiring conversion to general anesthesia. Conclusion: Ultrasound-guided supraclavicular brachial plexus block offers faster onset, prolonged blockade, reduced analgesic requirements, and fewer complications compared to the conventional technique, making it a superior choice for upper limb surgeries.

Background: A matter of concern in the end result of the elective abdominal surgeries are   postoperative wound complications. Wound infections and dehiscence, sinus, fistula formation and incisional hernia are the common challenges faced by surgeon. This study was conducted to determine the incidence of wound complications in elective abdominal surgeries. Methods: In this study 150 patients in the age group between 18–60 years, who underwent elective abdominal surgery in the Department of Surgery of a medical college were included. Patients were followed up for 6 months from time of surgery. Wound complications like infections, discharge, dehiscence, sinus, fistula and incisional hernia were noted. Results: Wound complication rate of 7.34% was found in the present study. Purulent discharge was the most common complication and E.coli was detected in majority of such cases. Wound dehiscence occurred in (3.3%) cases with wound infection. 2.66% cases developed incisional hernia, all of whom had wound infection in post-operative period. The patients who developed wound complications were belonged to higher age group (46-60 years), was more common among females compared to males and was common among the patients who had low hemoglobin levels. Conclusion: Results showed a wound complication rate of 7.34% and purulent discharge was most common with 70% cases showing E.coli as causative pathogen. Wound dehiscence occurred in 3.3% cases and majority of these cases developed incisional hernia. The patients who developed wound complications were belonged to higher age group (46-60 years), was more common among females compared to males and was common among the patients who had low hemoglobin levels but these factors were not statistically significant. These findings suggest that wound complications do occur in elective abdominal surgeries. These can be reduced to a certain extent by careful case selection, improving Hb levels prior to surgery, using adequate prophylaxis and better surgical practices.

Background: Since Jardao’s 1857 discovery of the link between diabetes and hearing loss, numerous studies have been conducted on the subject, with both favorable and unfavorable findings. High blood sugar levels primarily affect the auditory system. Increased glucose in diabetes patients can damage the auditory system, both anatomically and physiologically. This study aims to compare the auditory acuity in hyperglycemic and normoglycemic individuals. Methodology: This is a hospital-based case-control study. The study participants will be randomly recruited from OPD and IPD of various departments in GIMS, Kalaburagi. 200 subjects were divided as Group A with 100 normoglycemic and Group B with 100 hyperglycemic. FBS, PPBS and HbA1c values were measured. Pure tone audiometry and OAE was performed for subjects. Results: A total of 200 individuals were randomly selected: 100 normoglycemic (Group A) and 100 hyperglycemic (Group B), aged 30-60. The age distribution was similar, with 33 in Group A and 46 in Group B aged 51-60. Both groups had equal sex distribution. Out of 39 individuals with hearing loss, 32 (82%) were in Group B. Severity was lower in Group A (6% mild, 1% moderate) compared to Group B (21% mild, 9% moderate, 2% moderately severe.) 30 patients in Group B had mild to moderate hearing loss, compared to 7 in Group A. Higher HbA1c levels correlated with increased severity of hearing loss. Conclusion: Hyperglycemic individuals showed higher prevalence and severity of hearing loss compared to normoglycemic controls, suggesting a link between glycemic control and auditory health.

Introduction: Complete Blood Count (CBC) and Peripheral Smear (PS) study are the basic common blood investigations requested by clinicians and we can diagnose the various clinical conditions like acute or chronic infections, Leukemoid reaction, and leukemia through WBC counts, Anemia sub types and bleeding disorders. Though the bio-markers of inflammation are numerous, the least expensive test of CBC can be used as a risk predictors of cardiovascular diseases (CVD). Methodology: A prospective cohort study conducted on 60 study participants in whom 40 were taken from cases admitted with chest pain in emergency medical ward and 20 healthy individuals were taken as controls. This study was conducted at Chengalpattu Medical College for the period of 2 months [June 2024 to July 2024]. Results: The WBC count, Neutrophil Count, Lymphocyte Count, Neutrophil Lymphocyte Ratio (N/L), Platelet Lymphocyte Ratio (P/L) showed statistical significance with the p value of < 0.05. Majority of the peripheral smear picture showed Neutrophilia. Discussion: CBC offers variety of information to suggest the pathogenesis of many diseases. WBC count and Neutrophil lymphocyte ratio (NLR) can reflect systemic inflammation. Our study results showed that there is significant association with the parameters of WBC count, neutrophil count, lymphocyte count, Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio with the CVD risk. The peripheral smear picture also provides supportive evidence of neutrophilia in majority of the cases reflecting strong association with cardiovascular events. Many studies also stated these similar association of certain CBC parameters and CVD risk. Conclusion: CBC parameters such as elevated WBC count, N/L ratio, P/L ratio and peripheral smear can be considered as predictors as risk for cardiovascular events. However further larger studies are needed to support the potential role of CBC parameters and peripheral smear as these are least expensive and routinely assessed set of investigations for CVD risk in previously healthy populations.

Background and Objectives: This observational prospective study was carried out to assess and compare the outcome of non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC) therapy as respiratory support in patients suffering from acute hypoxemic respiratory failure. Methods: This study included 137 patients. The modality of respiratory therapy was determined by the treating physician, and 60 and 77 patients received HFNC and NIV as initial respiratory support, respectively. The patients were followed for 28 days or till death (whichever was earlier). The primary outcome was number of ventilator-free days and secondary outcomes were duration of respiratory support, need for intubation, and duration of ICU stay and hospital stay and 28-day mortality after initiation of respiratory support. Results: It was observed that the number of ventilator-free days (primary outcome) at day 28 was similar in both HFNC group (median 28 days) and NIV group (median 28 days). The 28 day mortality was found to be lower in HFNC group (28.3%) than in NIV group (39%) but it was not statistically significant (p 0.26). The intubation rate was also lower in HFNC group (33.3%) compared with NIV group (48.1%) but this difference was not statistically significant (p 0.12). The duration of initial support with HFNC (3 days, IQR 3-7) was significantly less than with NIV (5 days, IQR 1.25-6; p<0.05). The duration of ICU stay [8 days (IQR 5-12) vs 13 days (IQR 7.5-17.5)] and hospital stay [13 days (IQR 11-18) vs 18 days (IQR 11-25)] was significantly lower in HFNC group compared with NIV group (p<0.05). Conclusion: It is concluded that HFNC was a better modality of respiratory support, as its use is associated with shorter ICU and hospital stay, more number of support-free days and it is required for lesser duration than NIV, though there is no difference in number of ventilation-free days, endotracheal intubation rate, or mortality rate at day 28 from initiation of respiratory support.

Background: Cataract surgery is one of the most frequently performed ophthalmic procedures worldwide. Peribulbar block is a commonly used regional anesthesia technique for these surgeries due to its safety and efficacy, particularly in elderly patients with comorbidities. This study aimed to evaluate the effectiveness of a combination of lignocaine, bupivacaine, and hyaluronidase with and without clonidine at two doses (0.5 µg/kg and 1 µg/kg) for enhancing the quality and duration of analgesia during peribulbar anesthesia. Materials and Methods: This randomized, double-blind, prospective study was conducted on 120 patients aged 40–80 years undergoing cataract surgery at a tertiary care hospital in Pune, India, over one year. Patients were randomized into three groups of 40: Group A received a mixture of lignocaine, bupivacaine, and hyaluronidase; Group B received the same mixture with 0.5 µg/kg clonidine; and Group C received the mixture with 1 µg/kg clonidine. The onset of sensory and motor blockade, duration of analgesia, and hemodynamic parameters were assessed. Statistical analyses included Bartlett’s χ² test, Kruskal-Wallis one-way ANOVA, and paired Student’s t-test. Results: The addition of clonidine significantly reduced the onset time for sensory blockade (Group A: 4.7 ± 2.1 min; Group B: 3.7 ± 1.5 min; Group C: 3.2 ± 1.2 min) and motor blockade (Group A: 7.3 ± 2.6 min; Group B: 4.2 ± 2.4 min; Group C: 3.5 ± 1.2 min). Clonidine also prolonged the duration of analgesia, with values of 187.6 ± 23.1 min, 243.2 ± 27.0 min, and 341.3 ± 32.1 min for Groups A, B, and C, respectively. Hemodynamic parameters and side effects, including mild sedation and dry mouth, were within acceptable limits. Conclusion: Clonidine is an effective adjuvant in peribulbar block, enhancing the quality of anesthesia by reducing onset time and prolonging analgesia. The 0.5 µg/kg dose provides an optimal balance of efficacy and safety, making it a preferred choice for cataract surgery. Further studies with larger populations are recommended to validate these findings.

Background: Visual impairment in childhood has a negative impact on socio-emotional competence and academic development. As the real India is in villages, hence rural eye health status of rural school-going children was evaluated. Method: Out of 350 (three hundred and fifty) school-going children, 220 (62.8%) were male, and 130 (37%) were female and had ocular morbidities. Visual acuity was measured by Snell’s chart. The Hirschberg test, a cover-uncover test for the detection of squint, was done. A torchlight was used to examine the anterior chamber, iris, and pupil. Retinoscopy was used to study refraction. Ophthalmoscopy is the study of the fundus slit lamp for the anterior segment. Any pathology of the eye is treated with suitable antibiotics.  Results: 256 (73.1%) refractive errors, 138 (39.4%) simple myopia, 64 (18.3%) hypermetropia, 52 (14.8%) strabismus, 45 (12.8%) alternate convergent squint, 18 (5.1%) Vit. A deficiency is noted. Conclusion: The visual morbidities refractive error is a common eye health problem.  These findings will help the ophthalmologist to treat and prevent blindness in children.

Background: Tuberculous lymphadenitis presents significant diagnostic challenges, particularly in high tuberculosis (TB) burden settings. Traditional diagnostic methods like fine-needle aspiration cytology (FNAC) are widely used but often lack sensitivity and specificity. Methods: This cross-sectional observational study compared the diagnostic accuracy of GeneXpert/CBNAAT with FNAC in 970 patients suspected of having tuberculous lymphadenitis at a tertiary care center from January 2022 to December 2024. Data on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were analyzed and compared between the two methods. Results: GeneXpert/CBNAAT demonstrated significantly higher sensitivity (96.4%) and specificity (98.1%) compared to FNAC, which showed a sensitivity of 84.9% and specificity of 95.2%. The turnaround time for GeneXpert results was approximately 2 hours, compared to 48 hours for FNAC. GeneXpert also provided immediate insights into rifampicin resistance, enhancing the management of potential drug-resistant cases. Conclusion: GeneXpert/CBNAAT outperforms FNAC in both diagnostic accuracy and turnaround time, supporting its use as a primary diagnostic tool for tuberculous lymphadenitis in tertiary care settings. The rapid, accurate detection and added capability of assessing drug resistance make GeneXpert a valuable asset in the effective management and control of tuberculosis.

Background: Gestational diabetes mellitus (GDM), a common pregnancy condition, causes insulin resistance and harms the mother and foetus. We need early prevention to reduce its impact. Myoinositol, a naturally occurring sugar alcohol, may prevent GDM due to its role in insulin signaling and glucose metabolism. Objective: This study examined whether myoinositol supplements could lower the risk of gestational diabetes mellitus (GDM) in high-risk pregnant women and improve mother-child health. Method: Nalanda Medical College & Hospital conducted Retrospective observational research on 100 pregnant women from September 2022 to September 2023. Participants chose myoinositol supplements or prenatal care. We examined maternal-fetal outcomes, GTTs, and baseline characteristics. We used chi-square tests, paired t-tests, and logistic regression to determine how well myoinositol reduces GDM and affects mother and baby health. Results: Compared to the control group, myoinositol significantly reduced GDM from 36.7% to 14.3% (p = 0.01). The intervention group significantly improved (p < 0.05) glycaemic indices, including fasting glucose, postprandial glucose, and 2-hour OGTT levels. Myoinositol supplementation lowers the risk of preeclampsia (adjusted OR: 0.32; p = 0.04) and improves neonatal outcomes like Apgar scores and macrosomia. We found no major adverse effects. Conclusion: Myoinositol is safe and helpful for preventing GDM and producing a healthy baby. When used in prenatal care, it is feasible and cost-effective, especially for high-risk women. These findings need further study to determine long-term benefits.

Background: Mental health disorders include unfavorable drug effects, cognitive impairments, and decreased treatment adherence, making it harder to manage Diabetes Mellitus (DM), a chronic condition that requires ongoing management. This study will evaluate diabetic and mental patients’ glycaemic control and treatment results based on HbA1c levels, adherence, and lifestyle changes. Methods: 100 patients with diabetes for six months or more participated in the cross-sectional observational study. There were 50 mental patients and 50 community members. Participants were at the age range from 30–50. A structured questionnaire collected data on medication adherence, HbA1c levels, and lifestyle factors like food and exercise. Our statistical analysis was conducted using SPSS with a significance criterion of p<0.05. Results: General population HbA1c levels were 7.2 ± 1.0%, while psychiatric patients had significantly higher levels at 8.5 ± 1.2% (p<0.01). Compared to the general Population (7.8 ± 1.7), people with a mental health condition exhibited significantly worse treatment adherence (5.2 ± 2.3) (p<0.01). Psychiatric patients reported lower levels of physical activity (32% vs. 64%, p<0.05) and adherence to healthy nutrition (42% vs. 72%, p<0.01). No significant differences were found in alcohol and smoking rates. Conclusion: This study found that mental health patients are less likely to adjust their lifestyle, control their glycaemic levels, and follow treatment regimens. These findings suggest that mental diabetes patients need extra attention to medication adherence and lifestyle promotion. Integrated care techniques for patients with mental illness and diabetes are needed for better long-term outcomes.

Background and Aim: In light of the growing global awareness and advancements in socioeconomic and living conditions, there has been a concerning rise in the prevalence of diabetic osteomyelitis (DOM) and its associated complications. This research aimed to evaluate the efficacy of antibiotic-impregnated beads for the treatment of osteomyelitis in individuals with diabetic foot conditions within an Indian context. The research additionally examined the microbiological characteristics of the wounds. Material and Methods: The study included all diabetic patients who had a chronic foot ulcer persisting for over three weeks, along with confirmed underlying osteomyelitis through culture results. The current main study involved a total sample size of 120 participants. The participants were assigned to the two groups in a random manner. Patients were divided into two distinct categories: the ‘bead’ group and the ‘no bead’ group. In the study, the ‘bead’ group received antibiotic beads, while the ‘no bead’ group was administered oral antibiotics, alongside empirical intravenous antibiotics for both groups. Patients underwent a comprehensive review over a six-month period, with ulcers that did not show signs of healing within this timeframe classified as instances of treatment failure. Results: The findings of our study revealed a comparison of ulcer healing between two groups. Out of 120 patients involved, 102 experienced healing, while 18 did not achieve this outcome. Among the nine cases that did not heal, 14 were from the no bead group, while 4 were from the bead group. Among the 102 individuals who demonstrated healing, 46 were part of the group without beads, while 56 were in the bead group. The association regarding healing showed no statistically significant results. (p>0.05) The average healing time for the group without beads was 75.25±29.40 days, while the bead group recorded an average of 80.97±28.36 days, a difference that did not reach statistical significance. Conclusion: The application of antibiotic beads enhances patient convenience by minimizing hospital visits and the necessity for daily dressing changes, all while maintaining an effective healing rate. The group without beads faced challenges in accessing hospitals on a daily basis, with some individuals even opting to forgo their daily dressings due to personal inconveniences.

Background: Chronic suppurative otitis media is a very common middle ear disorder, particularly in developing nations like India. The surgical treatment of chronic suppurative otitis media primarily aims at the eradication of the disease process and reconstruction of the conductive hearing mechanism. Tympanoplasty is a surgical procedure to reconstruct sound-conducting apparatus, tympanic membrane, and ossicular system with or without grafting. Aim: Comparing the effectiveness of endoscopic cartilage shield tympanoplasty and endoscopic temporalis fascia, as well as the anatomical perforation closure and audiological improvement following cartilage and temporalis fascia. Methods: 40 people with a clinical diagnosis of chronic suppurative otitis media tubotympanic illness participated in the study. They were split into two groups at random: the temporalis fascia group and the cartilage group. A cartilage or temporalis fascia graft was used for tympanoplasty. Results: A lower failure rate was observed in the cartilage group than in the temporalis fascia group. The audiological gain between two groups showed statistically significant (p-value = 0.769). Impedance audiometry showed a ‘B’ curve in all cartilage tympanoplasty patients. Conclusion: For tympanic membrane repair, cartilage is a dependable and long-lasting graft that can resist harsh environments for an extended length of time. Better anatomical and functional outcomes are obtained with cartilage tympanoplasty.

Background: Metabolic syndrome is constellation of many different disorders. The common conditions associated with metabolic syndrome are obesity, hypertension, and dyslipidemia and insulin resistance. These conditions do play some role in developing cardiovascular disease beyond traditional risk. Metabolic syndrome have been commonly seen in patients of many skin diseases including psoriasis, lichen planus, acne inversa and even in skin malignancies. In chronic skin disorder and even in metabolic syndrome chronic inflammation has been shown to play some role in the pathogenesis of disease. The present study is designed with a view to know any association between skin diseases especially psoriasis and metabolic syndrome. Materials and Methods: Present study was conducted on 100 clinically confirmed cases of Psoariasis & 100 age and sex matched healthy controls. Detailed history and clinical examination was conducted for both cases & controls. Blood pressure, waist circumference & body mass index were recorded. Blood fasting glucose levels and lipid profiles were also measured for both groups. Statistical analysis was done using descriptive statistics and Chi-square tests were used to assess the significance of the differences between the two groups. Data analysis was performed using SPSS and EPI info software. Results: Among psoriasis patients 26/100 had metabolic syndrome. The incidence of metabolic syndrome with skin disease was high as compared to control population and it was also statistically significant. Conclusion: It was concluded from this study that metabolic syndrome is an important co-morbidity with psoriasis which requires screening to avoid complications in later life.

Background: Androgenetic alopecia is a very common clinical condition encountered by the dermatologists in their daily practice. Aims: To study the efficacy of platelet rich plasma in treatment of androgenetic alopecia in male patients. Settings and Design: Observational and interventional study. Methods: A total of 30 cases of clinically diagnosed male patients with androgenetic alopecia in the age group of 15-50 years constituted the subject material for present study. Detailed history and clinical examination of cases was done. All the routine investigations were carried out. Statistical analysis used: Data analysis was done by using statistical package for social sciences (SPSS) and “paired t test”. Results: A total of 30 patients were studied. Large number belonged to the age group 26-30(36.7%) years and 21-25 years (33.3) respectively. Majority are from class 2 to 5, Hamilton Norwood classification of AGA. The family history was positive in 19 cases (63.3%). Frontal, parietal and occipital areas were involved in maximum number of patients i.e. in 20 patients (66.7%). The patients reported clinical improvement in the form of hair count, hair thickness, hair density with statistically significant p-value (p<0.05) after an average of 2-3 sessions. Conclusion: In our study of 30 patients, 20 patients showed improvement of varying degrees ranging from +1 to +7 according to Jaeschke scale with significant p-value (p<0.05) after treatment with platelet rich plasma(PRP) based upon which we conclude that platelet rich plasma(PRP) is efficacious in the treatment of androgenetic alopecia.

Background: Approximately 10% of preterm births occur globally (before the 37th week of pregnancy). Research on ROP occurrence in populations is a difficult task due of the wide variation in research design, gestational age, and survival rates among those who participate in these studies. Therefore, our goal was to study  the prevalence of retinopathy of prematurity & associated risk factors. Objectives: To determine the prevalence of retinopathy of prematurity in preterm babies in Neonatal intensive care unit and to understand the link between ROP development and risk variables. Methodology: preterm less than 35 weeks newborns delivered between April 2023 to March 2024 were included in the study. Preterm newborns who need cardiorespiratory assistance, extended oxygen treatment, apnea of prematurity, anaemia necessitating blood transfusions, and neonatal infection might be considered high-risk. Results: Out of 100 patients, 58 were males and 42 were females. The prevalence of ROP in this research was found to be 27%.Stage 1 ROP was found in 8% of patients, stage 2 ROP was found in 19% of cases, and stage 3 ROP was found in 73% of cases. In the present study, risk factors for ROP are low APGAR score, HIE stage, capillary refilling time, NBS score, RDS, neonatal hyperbilirubinemia, and ionotrope usage.

The human forearm is a unique structure in that the movements of pronation and supination occur at the forearm. This is primarily due to the curved anatomy of the radius which helps it to glide over the ulna. In the anatomical position, the medial cortex of the radius is concave while the lateral cortex is convex. This curve otherwise called the ‘radial bow’ of the radius, gives the forearm the ability to pronate and supinate resulting in a ‘screwing motion’. In our study we aimed to assess the radial bow in a subset of Indian population. This study looked at the amount of radial bow present and its location on the radial diaphysis. We tried to find out whether Gender and Hand Dominance affected radial bow and its location.

Background: Tuberculosis (TB) remains a major global health challenge, particularly in low- and middle-income countries, with India bearing the highest burden of cases worldwide. Zinc, an essential micronutrient crucial for immune function, has been implicated in TB susceptibility and treatment outcomes, yet its role in pediatric TB remains underexplored. Objectives: The primary objective of the study was to estimate the levels of serum zinc among patients with childhood pulmonary tuberculosis and TB lymphadenitis. The secondary objectives were to determine the correlation between serum zinc levels and patients’ nutritional status, clinical type of TB and duration of ATT. Methods: This was a hospital-based case control study conducted in the Department of Paediatrics, Vinayaka Missions Medical College and Hospital, Karaikal, over a two-year period from August 2016 to June 2018. Results: The study evaluated serum zinc levels among 48 children with tuberculosis (cases) and 12 healthy children (controls). The mean serum zinc levels were significantly lower in cases (79.56 ± 13.40 µg/dl) compared to controls (120.97 ± 20.73 µg/dl; p<0.001). Decreased zinc levels were observed in 27.1% of cases, while none of the controls had low zinc levels (p=0.042). Among cases, children under 5 years had the lowest mean zinc levels (73.61 ± 12.22 µg/dl), followed by those aged 10–15 years (77.26 ± 15.02 µg/dl) and 5–10 years (83.11 ± 12.76 µg/dl), though differences were not significant. Gender differences in serum zinc levels were also not significant in either group. In cases, malnourished children had slightly higher serum zinc levels (81.14 ± 11.96 µg/dl) than well-nourished children (77.98 ± 14.81 µg/dl; p=0.421). In controls, however, malnourished children had significantly lower zinc levels (100.23 ± 8.71 µg/dl) compared to well-nourished children (127.89 ± 18.89 µg/dl; p=0.038). Cases with extrapulmonary TB showed higher zinc levels (82.15 ± 11.39 µg/dl) than those with pulmonary TB (78.14 ± 14.37 µg/dl; p=0.326). Zinc levels increased significantly with longer ATT duration, ranging from 68.04 ± 10.07 µg/dl (0–1 month) to 93.64 ± 8.82 µg/dl (3–4 months; p<0.001). No significant correlation was observed between serum zinc levels and age in either group. Conclusion: Serum zinc levels were significantly lower in children with tuberculosis compared to healthy controls, with malnutrition contributing to the severity of zinc deficiency. Zinc levels improved with the duration of anti-tubercular therapy, highlighting its potential as a marker for nutritional and treatment recovery.

Simulation based medical education is defined as any educational activity that utilizes simulation aides to replicate clinical scenarios. The use of simulation has been in practice from a long time in fields like aviation, but as far as medical science is concerned its use is relatively new. Although expensive, its judicious use can go a long way in helping both students and teachers teach and learn various skills in a safe and controlled setting without harming the patients. In this article we present our experience in simulation based teaching to undergraduate medical and nursing students at our skill labs over a period of 2 years.

Background: Administering sedation during endoscopic therapy is crucial due to the significant amount of time it takes. Despite being less intrusive and time-consuming compared to endoscopic treatment, endoscopic examination typically causes patients to suffer pain and discomfort in the absence of sedation. Conscious sedation is often achieved by the administration of a narcotic and/or a benzodiazepine. Midazolam, with the briefest half-life among traditional benzodiazepines, is commonly provided either on its own or in conjunction with opioids like fentanyl or pethidine in several countries. Dexmedetomidine is a potent alpha2-adrenoreceptor agonist that specifically targets these receptors, resulting in sedation, pain relief, and reduced saliva production. Dexmedetomidine provides cardiovascular stability, exerts low impact on respiration, and has negligible effects on cognitive functions. Objective: To compare Dexmedetomidine and Midazolam for a conscious sedation in patients undergoing Upper Gastrointestinal Endoscopy. Methodology: The present study was carried out at Department of Anesthesiology at MIMER Medical College, Talegaon Dabhade involving the patients undergoing diagnostic and therapeutic upper gastro intestinal endoscopy procedure. A total of 44 patients were randomly divided in to two groups, 22 each group; Group M received Inj. Midazolam IV and group D received Inj. Dexmedetomedine IV by computer generated random number table. Results: Mean time to achieve sedation i.e. Ramsay sedation grade 3-4 was 8.91 mins for Dexmedetomidine and 8.82 mins for Midazolam, with no difference between study groups (p=0.797). Mean Ramsay sedation score at baseline, after 5 min, after 10 min, after 15 min, after 20 min, after 25 min, after 30 min, after 35 min, after 40 min, after 45 min, after 50 min, after 55 min, after 60 min was recorded. We observed that the mean scores were comparable between the groups during the initial phase of the procedure. However, the mean sedation score was significantly higher in the dexmedetomidine group compared to the midazolam group during the latter part of the procedure i.e at 55 minutes and 60 minutes time interval, indicating that sedation was more effectively maintained with dexmedetomidine group. Additional sedation was required in 5 cases managed by midazolam as compared to only 1 case managed by dexmedetomidine (22.7% vs. 4.5%; p – 0.03). Conclusion: Present study observed that both Dexmedetomidine in a dose of 1 mcg/kg/iv bolus over 10 min followed by infusion 0f 0.2 mcg/kg/hr and Midazolam in a dose of 0.06 mg/kg required similar amount of time to achieve sedation, however, the sedation was sustained more effectively with Dexmedetomidine, and additional sedatives were required more often in patients that were sedated with Midazolam.

Melioidosis is caused by a gram-negative bacterium called Burkholderia pseudomallei which can be contracted through contaminated soil and water. Mostly prevalent in Southeast Asia and south India, northeast India. It has varied presentations like pneumonia, septicemia, abscess, encephalopathy, arthritis and so also fulminant and chronic courses of illness. A 40 year old, diabetic male presented with high grade fever for 10 days, burning micturition for 10 days and hiccups for 2 days and next day developed altered sensorium, irrelevant talks. Patient was febrile (temp. 101.4^⸰F), oriented to time, place and person but the next day he was disoriented euphoric. Lab investigations showed pancytopenia, Hyponatremia (Na+ 126), deranged KFT (creatinine -2), deranged LFT, raised CRP (58), .CSF culture was negative. MRI brain was showing Grade 1 Fazeki’s white matter changes. Blood CST showed Burkholderiapseudomallei. Gram negative bacilli were seen on Gram stain. He was treated with inj Meropenem, inj Doxycycline, inj Ceftazidime Avibactam, oral Amoxicillin and clavulanic acid. Eventually his sensorium improved, was conscious oriented, fever subsided. The patient was discharged with oral Cotrimoxazole DS (800/160) as maintenance therapy for 6 months and is currently doing well.

Background: Epistaxis is commonly encountered problem in ENT OPD but few require medical attention. Aims: To find out the incidence of epistaxis, age & Sex distribution of patients, month of presentation, duration of hospital stay among the patients, etiology of epistaxis, and modalities of management of patients admitted for Epistaxis in the Department of ENT, Lakhimpur Medical College, Assam. Methods: This study is retrospective review of patients admitted in the Dept of ENT, Lakhimpur Medical College, Assam from the period 1^st Jan 2022 to 31^st Dec 2023. Result: The incidence of patients admitted with epistaxis was found to be 17.6%. Most patients were found in the age group 41-50 years [24.5%]. Male to female ratio was 2.2:1. Incidence of epistaxis increased in the winter months. Predominant causes of epistaxis was found to be hypertension [49%] followed by Trauma [19%]. Majority of the cases were managed by Anterior Nasal Packing [ANP] with antibiotic lubricant gauge pack & Merocele [64%]. 20% cases were controlled with conservative management. Surgical intervention was required in 13% cases. Conclusion: Epistaxis causes significant contribution to morbidity. Control of bleeding, reduction of hospitalization, low complications are the goals of treatment. Major causes of epistaxis are Hypertension and Trauma. Primary modality of management is ANP followed by surgical intervention. Endoscopic cauterization of bleeding point & endoscopic cauterization of Sphenopalatine artery gives promising results.

Introduction: Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. The proximal tibial fractures are one of the commonest intraarticular fractures. They result from indirect coronal or direct axial compressive forces. The majority of tibial plateau fractures are secondary to high speed velocity accidents and fall from height. This study evaluates the functional outcome of high energy tibial articular fractures treated with use of single/dual plating. Material & Methods: The prospective study conducted in the Department of Orthopaedics, MLB Medical College Jhansi from May 2019 to Oct. 2020 on 40 patients of proximal tibia fractures. The cases who were 19-49 years, unilateral, closed fractures, proximal tibial fractures (Schatzker type 1 to VI) with no previous involvement of ipsilateral leg in surgery were included in the study. Results : The youngest patient was 19yrs old and the oldest was 47 yrs. Majority of the fracture were found to be type IV,V and VI fracture types. Most fracture union occurred between 4-5 months. Most of the cases were fell under good modified Rasmussen clinical score 45.0%, followed by excellent 30.0%. Most of the cases were fell under excellent modified Rasmussen radiological score 47.50%, followed by good 30.0%. Knee stiffness, knee instability, implant prominence and infection are the complications occurred in study.

Conclusion: Locking compression plate is mechanically and biologically an advantageous implant in tibial plateau fractures and is effective in prevention of collapse after osteosynthesis, thus allowing early mobilization.

Introduction: Diabetes mellitus is a chronic, metabolic disorder characterized by hyperglycemia. The overwhelming increase of obesity is the first cause of Diabetes which is closely linked to the insulin resistance and associated with hypertension along with dyslipidemia, stress and altered antioxidant level. Yoga and meditation have beneficial effect in diabetic and hypertensive patients. Hence, the aim of this study is to assess the effect of yoga and meditation on lipid profile and antioxidant status in patients with Diabetes mellitus and Hypertension. Material and Method:  This  Prospective study, done at  MGM Medical college ,Mumbai , include 60 healthy control subjects and patients with Diabetes mellitus and diabetes with hypertension , enrolled from both MGM hospital kamothe, Navi Mumbai and International Sahaja which Yoga Meditation and Research centre ,Mumbai. After  overnight fast, blood samples was collected from each subject by venipuncture with standard blood collection technique in a plain vial for  the analysis of lipid profile and MDA, SOD and Nitric oxide.  The Blood pressure (systolic/diastolic) was measured by Sphygmomanomete. Result: The concentration of MDA, Triacylglycerol (TG), Cholesterol and LDL-cholesterol were decreased significantly in diabetics and diabetic hypertensive subjects as well as in healthy individuals after Sahaja yoga meditation over a period of six month. The HDL-cholesterol, SOD, Nitric oxide concentration were increased significantly in healthy individuals as well as in diabetics and diabetic hypertensive subjects participated in Sahaja yoga meditation. Conclusion: This study confirms the health promoting effects of yoga meditation on lipid profile and antioxidant status in type 2 diabetic and diabetics with hypertensive patients over a period of six month, so it may be included as part of treatment regimen along with regular medication in patients of Diabetes with hypertension to improve the quality of life and to prevent the complications of diabetes.

Background: One of the commonest presentations of acute abdomen to hospitals is acute pancreatitis, which can have variable clinical presentations and outcomes from mild to severe life-threatening multi-organ dysfunction. Acute pancreatitis is a complex condition with diverse local and systemic complications, dealt by the surgeons all over the world and very few studies conducted regarding etiology, clinical profile and outcome in the rural areas of Andhra Pradesh hence, study was conducted to assess the clinical profile and outcome of acute pancreatitis. Methods: In this single arm prospective study 109 patients of all age group with acute pancreatitis were included over two years period. Patients’ demographic, clinical history was taken and clinical management and outcomes were noted. The data was analyzed by descriptive statistics. Results: Among 109 cases studied 85.32 % were males and mean age of the patients was 46.45±7.12 years. Epigastric pain without radiation to the back (56.9%) was the most common clinical presentation. Alcohol was the most common etiological factor seen in 43.1% followed by idiopathic pancreatitis (37.6% cases). Acute fluid collection was the most common local complication seen in 29.4% cases and respiratory system involvement was the most common organ involvement seen in 17.4% of cases and hypocalcemia (25.7%) was the common metabolic complication found in our study. Conclusion: In our study, we found that the abdominal pain is single most common symptom and in that epigastric pain not radiating to the back was presented as the commonest. Half of the people presented with triad of epigastric pain, nausea and vomiting. The common etiology in our study was alcoholic pancreatitis followed by idiopathic. The most common other system involvement found in our study was respiratory system and majority of them presented with mild CT severity index. Among the dead patients the most common etiological factor was alcohol and all of them died due to MODS.

Background: Ophthalmic pathology is unique in many aspects as it encompasses wide range of tissue – epithelial, connective tissue and specialized tissue. Knowledge of spectrum of ophthalmic lesions would contribute to the better management. Complete diagnosis is based on clinical as well as histopathological features. Clinico Pathological correlation is essential for early diagnosis and setting up proper management. Material and Methods: It was a retrospective study carried out at the department of pathology, North Bengal Medical College, and Hospital for a period of 3 years. Total 68 specimens were reviewed that were surgically operated at the department of ophthalmology. Results: In this study period total 68 histologic cases of ophthalmic lesions were observed. A wide spectrum of conditions ranging from non-neoplastic to benign, pre-cancerous and malignant lesions were detected. Eyelid was the most common site of lesion (64.70%). Neoplastic lesions were more in number in surgical specimen (79.5%). Epidermal cyst was most common lesion and basal cell carcinoma was the most frequently detected neoplastic lesion. Age range was from 4yrears to 81years, and highest numbers of cases were among 31-40 yeas age group. Conclusion: This study revealed the occurrence of wide range of non-neoplastic and neoplastic lesions in this region. Every surgically removed ocular specimen must undergo histopathological examination for definite diagnosis.

Objective: The purpose of this study is to investigate the relationship between a placenta that is laterally placed on ultrasonography and the onset of pre-eclampsia in maternal patients. Methods: A prospective longitudinal study was conducted at Hoskote tertiary center from August 2023 to August 2024. A total of 215 pregnant women between 18 and 24 weeks of gestation, who met the inclusion criteria, were recruited. Placental location was determined via ultrasound, and participants were followed up regularly until delivery. Data on the development and severity of pre-eclampsia, maternal complications, neonatal outcomes, and NICU admissions were collected and analyzed. Results: Out of 215 women, 27 (12.56%) developed pre-eclampsia, with a significantly higher proportion (70.38%) having a placenta (lateral) compared to a placenta (central) (29.62%) (p = 0.0014). Severity of pre-eclampsia was greater in the placenta (lateral) group, with 42.11% of severe cases compared to 25% in the placenta (central) group (p = 0.0056). Maternal complications such as eclampsia, IUGR, HELLP syndrome, and PPH were more frequent in pre-eclamptic women with placenta (lateral). Neonatal outcomes showed lower APGAR scores at the 1st minute and higher NICU admissions for pre-eclamptic women with placenta (lateral) (p = 0.0003 and p = 0.0008, respectively). Conclusions: Placental (lateral) location is significantly associated with the development and severity of pre-eclampsia. This association underscores the potential of using placental location as an early screening tool for predicting pre-eclampsia, enabling timely intervention and management to improve maternal and neonatal outcomes.

Asthma is the most common childhood disease and is rising in developing countries. The accessibility of latest diagnostic methods helps to improve knowledge of the pathophysiology of bronchial asthma. Interaction between genetic and environmental factors is seen to influence development of asthma. The assessment of severity of asthma is essential to decide the initial treatment and to know response of therapy later on. In emergency room, major drawback to attend acute asthma patient is non-availability of special equipment for spirometry and well-trained staff for performing the test and subsequent interpretation of results, so in such cases PEFR used for severity assessment. Other asthma scoring systems are being used that club together physical signs. These include respiratory rate and accessory muscles use in younger children and children with severe airway obstruction. In these patients it is not easy to perform both Spirometry and PEFR as they have difficulty in performing expiratory maneuvers. There are up to 16 severity scoring systems. Most of them use parameters like the blood gas analysis and others require challenging parameters such as inspiratory /expiratory ratios. Hence, for children with acute asthma exacerbation, mPIS provides an easy tool for assessing the severity. Inclusion Criteria: (1) 6-18 years aged Children with mild to moderate Exacerbation of asthma. (2) Children 8 years and above and Parents willing to give signed informed consent. Exclusion Criteria: (1) Refusal of consent. (2) Conditions affecting the pulmonary function like immunosuppressive, cardiac & neurological condition. (3) Children with Chronic pulmonary disease. (4) Acute respiratory infection. (5) Children who are not able to perform peak expiratory flow rate. Results: The mean predicted PEFR improved with treatment by 15.26% (from 112.7% to 172.9% of predicted) (p<0.0001) at 15 min. The mean mPIS improved by 4.2 (from 5.5 to 1.31) (p<0.0001) at 15 min. Pre & post-treatment mPIS’s were significantly correlated with PEFR. The correlation of pre-treatment PEFR and mPIS is r = -0.534 (p=0.000), that for post-treatment at 15 min is r = -0.403 (p=0.000). Conclusion: The mPIS is a handy method for evaluation of airway obstruction. This has higher post-treatment association for smaller airway obstruction than larger airway obstruction. This is a better method to evaluate the mild severity of the disease. It also helps to know treatment response. Most scoring systems are imperfect. So, when spirometry testing & PEFR can’t be performed some alternate technique of checking the severity is necessary. The mPIS appears to be easy tool for the evaluation of airway obstruction. It can be used to asses post-treatment response and to standardize the treatment protocol.

Introduction: Reduced susceptibility of carbapenems against enterobacterial strains have emerged as an important public health problem. Infections caused by Carbapenem Resistant Enterobacteriaceae (CRE) can affect severely ill patients. Human gastro intestinal tract is the important reservoir for Enterobacterales and the enteric bacteria harbour the resistant genes which could be transmitted through food handlers. Aim: To find the different Enterobacterale isolates in the stool sample of the dietary workers and estimate prevalence of (CRE). Materials and Methods: Descriptive cross-sectional study was conducted in tertiary care hospital in Tamil Nadu for the period of 4 months(September 2024-December 2024). 360 stool samples were collected from the dietary workers. Enterobacteriaceae isolates  in the stool sample were identified by conventional biochemical tests.CRE was confirmed by Modified Hodge test (MHT).Statistical test was done by SPSS software version 23. Descriptive statistics was used. Results: Out of the 360 samples received, 38 samples of CRE were studied(CRE prevalence-10.5%).There was male predominance with male to female ratio 1.9: 0.5. Among CRE isolates, 22(57.89%) were Escherichia coli, 11(28.94%) were Klebsiella pneumoniae, 3(7.89%) were both Escherichia coli and Klebsiella pneumoniae, 1(2.63%) was both Escherichia coli and Enterobacter spp and 1(2.63%) was both Escherichia coli and Citrobacter spp. Most common resistance was seen for Meropenem (52.6%) followed by Imipenem (44.7%) and 26% were positive for MHT. Conclusion: Silent carriers may be important source of the transmit of infection from hospital to community. Screening regularly (twice yearly) for CRE isolates and health education on safe food handling practices may prevent the acquisition and spread of CRE infection among food handlers.

Background and aim: Anemia is the most common hematologic abnormality identified in infants and children. The present study was conducted to evaluate the hemoglobin values in pediatric age group by Sahli’s acid hematin method, cyanmethemoglobin method and automated hematology analyser and to compare and contrast sahlis acid hematin method and automated analyser with respect to cyanmethemoglobin method for hemoglobin estimation and to evaluate the diagnostic accuracy of both. Material and Methods: This is a cross-sectional study. Blood sample was collected in two EDTA vials from 100 outdoor patients in the age group 1 year to 12 years attending CCL Pathology .The hemoglobin values of the collected blood samples was analysed by Sahlis Acid Hematin ,cyanmethemoglobin method in the Department of Physiology and Automated Hematology Analyser(Elite 580,ERBA manheim) in the Department of Pathology. The methods were compared and analysed for diagnostic accuracy through chi-square tests and ANOVA. A value of <0.05 was regarded as statistically significant. Results: In our study, all three methods exhibit a similar level of repeatability, with standard deviations around 1.94–1.95. This indicates that all methods are consistent in their measurements with minimal variability. Sahli’s Method has a narrower prediction range (3.55–11.32), which might suggest lower reliability for measurements across the full spectrum of possible values. Cyanmethemoglobin and Automated hemoglobin show wider and more similar prediction ranges, indicating better capability to accommodate a broader range of hemoglobin values. Conclusion: In our study, all three methods exhibit a similar level of repeatability which indicates that all methods are consistent in their measurements with minimal variability. The Automated hemoglobin and Cyanmethemoglobin methods are likely more suitable for applications requiring higher reliability and coverage of a wide range of hemoglobin values. The Sahli’s Method, while consistent, might be less reliable for extreme or high values due to its narrower range.

Background: Even though minimal invasive techniques (Laparoscopy) are prevalent in treating or diagnosing acute abdominal surgical emergencies or Non-specific Abdominal Pain (NSAP), but their adoption as a routine procedure has been slower compared to elective procedures. It is due to concerns about inadvertent injuries and longer operative times. Laparoscopy has proven to be a safe and effective diagnostic tool for patients with unexplained abdominal pain. For conditions like appendicitis, perforated peptic ulcers and Cholecystitis, minimally invasive surgery is now considered the preferred approach. In trauma cases, laparoscopy has demonstrated utility and may eliminate the need for laparotomy in certain situations. Aim of the Study: To examine the diagnostic and therapeutic role of early laparoscopy in the management of acute abdominal surgical emergencies or Non-specific Abdominal Pain (NSAP). Materials: The study involved 57 patients admitted with acute abdominal emergencies clinically presenting with pain in the abdomen supportive laboratory and radiological investigations. They were randomly divided in to two groups: Group A (29 patients): In this early Laparoscopy was done within 18 hours. In Group B (28 patients):  clinical Observation and Lab reports follow up done for 48 hours followed by Laparoscopy after 48 hours in the patients with persistent situation. Data were collected on postoperative hospital stay, laparoscopy-related complications, hospital readmissions, final diagnoses, and response rates. Results: The mean patient age was 28.14±09.20 years, with a male-to-female ratio of 1:85:1. 39/57 (68.42%) patients were aged between 20 and 35 years. The most common presenting symptoms were abdominal pain, nausea, and vomiting. Laparoscopic findings revealed appendicitis in 20/57 (35.08%), gynecological pathologies in 18/57 (31.57%) and intestinal obstruction due to bands and adhesions in (24.56%) patients, Blunt trauma to GIT, spleen and liver and penetrating trauma were noted in 05/57 (08.77%) patients. In Group ‘A’ patients had low radiation exposure than in Group B patients (p-0.021) which was significant noted. Diminishing VAS scores of pain on the 1^st, 3^rd and 7^th days was noted in Group B (p-0.001) which was significant noted. Consumption of analgesics was significant in both the group A and B (p-0.001) and Nil analgesics (p<0.01), and nil-by-mouth status (p- 0.01). In Group A patients Hospital stay was shorter with p value less than 0.001, in comparison to Group B patients it was extended stay (p value <0.05) The overall definitive diagnosis was achieved in 27/29 (93.10%) of cases in Group A patients and 22/28 (78.57%) in Group B. Conclusion: Early laparoscopy intervention proved to be significantly effective in managing acute emergencies of the abdomen. The procedure provided a superior diagnostic accuracy to the surgeon, facilitated early discharge, and reduced the chances of not indicated laparotomy procedures.

Background: The hallmark of mild cognitive impairment (MCI) is impairment in one or more cognitive domains, which might make it difficult to carry out daily tasks while retaining one’s independence and autonomy. Lack of sleep has been demonstrated to affect the efficiency of general anesthetics in rats, resulting in delayed emergence from anesthesia or hypersensitivity to induction of anesthesia. Aim: To analyze effect of mild cognitive impairment (MCI) and MCI with sleep disorders on the potency of sevoflurane anaesthesia. Method: The GMERS Medical College, Junagadh, Gujrat Hospital’s Ethics Committee examined and authorized this clinical investigation. The patients and their families completed an informed permission form after being properly told about the study before it was carried out. Individuals between the ages of 60 and 75 who had a body mass index (BMI) between 18.5 and 23.9 kg/m² were chosen for unilateral radical mastectomy. The statistical program SPSS 26.0 was utilized to analyze the data. A two-sample t-test was used to compare groups, and measurement data with a normal distribution were displayed as mean ± standard deviation (x¯±s). Result: numbers of patient in both group M = 25 and MS = 26. The mean age of these group members was 65.22 ± 2.62 for M group and 64.31 ± 3.37 for MS group. Moreover, the BMI of these groups was 21.63 ± 1.32 for M and 21.36 ± 0.21 for MS. The analysis has also suggested MCH value which was 36.11 ± 3.12 for M and 22.24 ± 3.14 for MS group. Conclusion: Patients with MCI and sleep issues received larger doses of sevoflurane than patients with MCI alone. We also found a correlation between serum MCH level and the sevoflurane MAC value.

This prospective observational study focuses on patients diagnosed with hypokalemic periodic paralysis, with the objective of analysing their etiological, clinical, and metabolic profiles. The study population comprised patients admitted to the medical wards and the medical intensive care unit of a tertiary care center in Mumbai. The research was conducted over a duration of 18 months. Hypokalemic paralysis is a significant, treatable, and reversible cause of acute flaccid paralysis. However, limited Indian studies are available to guide the investigation and treatment within the Indian context hence the study was planned. This condition is also referred to as “sporadic paralysis” in some literature and, due to its recurrent nature, is classified as a type of “periodic paralysis.” Most cases are sporadic, while non-sporadic instances are exceedingly rare. Management strategies vary based on individual case scenarios Early diagnosis, prompt treatment, and necessary lifestyle modifications can lead to remarkable improvements in patient outcomes. These steps play a crucial role in the effective management of hypokalemic paralysis, reducing its recurrence and ensuring better quality of life for affected individuals.

Objective: To compare between the different doses of phenylephrine for the prevention of hypotension and which dose regimen is more responsible for producing adverse effects like bradycardia after spinal in caesarean section. Methods: A prospective, observational, comparative study in which 54 patients were included in the study with 18 patients in each of the three group. Group A: include cases which get 25mcg/min infusion of phenylephrine. Group B: include cases which get 50mcg/min infusion of phenylephrine. Group C: include cases which get 100mcg/min infusion of phenylephrine. The baseline blood pressure was measured . The Phenylephrine infusion was started just after giving the spinal anaesthesia at a dose as per the patient’s group. Heart Rate and Blood Pressure were measured at every 1minute interval intra-operatively till the delivery of the baby, and Apgar Score were measured at 1minute and 5 minute after the delivery of the baby. Any intervention like administration of atropine or administration of phenylephrine bolus were also noted. Results: Demographic differences between the three study groups were not significant. The decrease in heart rate (bradycardia) was statistically significant between three groups. (p value < 0.05) The episodes of hypotension were also statistically significant between the three groups. (p value <0.05). Bradycardia, Nausea, Vomiting were also not present with infusion dose of 50mcg/min. Conclusion: Phenylephrine infusion dose of 50mcg/min, prevents hypotension more effectively, after administration of Spinal anesthesia in Caesarean Section, as compare to infusion dose of 25mcg/min and 100mcg/min. Bradycardia, Nausea, Vomiting were also not present with infusion dose of 50mcg/min. Hence, Phenylephrine infusion dose of 50mcg/min, prevents hypotension more effectively.

Background: Selective nerve root block (SNRB) and Facet joint infiltration (FJI) are procedures that can be used as therapeutic modality for lumbosacral radiculopathy. Our study aims to investigate the clinical effectiveness of the use of fluoroscopically guided therapeutic selective nerve root block as a non-surgical symptom management of lumbosacral radiculopathy. Patients and Methods: This is an observational study of therapeutic nerve root block and Facet joint infiltration administered in 50 patients with low back pain and/or sciatica at tertiary care hospital. Data was collected by independent clinical interviewers, and The Modified Oswestry Low Back Pain Disability Questionnaire was used to measure pain severity and for post procedure relief of symptoms. Results: A total of 50 patients, 28 (56%) males and 22 (44%) females, underwent SNRB and FJI. 60% patients had good outcome whereas 34% patients had fair outcome. 64% patients had reduction in symptoms post-operatively. The difference between the outcome and post-operative symptoms was statistically significant (X² =4.24, p =0.38). Conclusion: Therapeutic SNRB with FJI is an important procedure in the pain management of patients with lumbar radiculopathy caused by lumbar disc prolapse and foraminal stenosis. Our study showed that 17 out of 28 males had good outcome whereas 13 out of 22 females had good outcome. 60% patients had good outcome whereas 34% patients had fair outcome. pain relief for at least 6 months was achieved in up to 64% of patients after a single SNRB with FJI. This makes it a very good second line of management after conservative treatment and a possible method to delay, and sometimes cease, the need for surgery.

Background: Supracondylar humerus fractures are among the most prevalent elbow injuries in children, accounting for 65–75% of all elbow fractures, particularly in those aged 5 to 8 years. These fractures commonly result from falls onto an outstretched hand, leading to posterior displacement. This study aims to evaluate the functional and radiological outcomes of displaced supracondylar humerus fractures treated with lateral K-wiring. Methods: This prospective cross-sectional study analyzed 50 cases of displaced supracondylar humeral fractures in children, treated with closed reduction and lateral pinning using Kirschner wires. Conducted at a tertiary care orthopedic department from July 2022 to December 2024, the study included children aged 3-13 years with Gartland Type 2 and Type 3 fractures. Exclusions included open fractures and neurovascular compromise. Postoperative assessments utilized Flynn’s criteria to evaluate outcomes at 4, 12, and 24 weeks post-surgery. Results: The cohort had an average age of 7.78 years, with a male predominance (78%). Falls were the primary cause (76%), and Type 3 fractures were most common (72%). The average interval from injury to surgery was 1.4 days, with an average hospital stay of 2.9 days. Postoperative complications included a 4% rate of pin tract infections and minimal restrictions in elbow flexion (average 5.1 degrees). According to Flynn’s criteria, 76% of patients achieved excellent outcomes, and 98% were classified as satisfactory. Conclusion: Closed reduction and lateral percutaneous pinning are an effective treatment for displaced supracondylar humerus fractures in children, yielding excellent functional outcomes with low complication rates. The findings underscore the necessity for preventive measures against falls in this demographic and support the continued use of this surgical technique in clinical practice.

Background: Total knee arthroplasty has revolutionized the care of patients with end stage arthritic conditions. Increasing life expectancy, growing demand and success of this surgery have lead to signicant increase in the number of total knee replacements. The present study was conducted to assess cases of total knee replacement in a tertiary care centre. Material and Methods: The present prospective study was conducted in the department of Orthopedics. It comprised of 30 patients of both genders in which TKA was performed. A thorough clinical examination and Radiological assessment was performed. All patients were assessed clinically using the Range of Motion and Knee Society Score pre operative and post operative. Statistical analyses were performed using SPSS 20.0. P value less than 0.05 was considered significant. Results: In the present study total participants were 30 in which 66.67% were male and 33.33% were females. The functional outcome was evaluated using Knee Society Scoring which showed significant increase in KSS at 1,6 and 12 months with improving knee function and patient quality of life over the course of a year. Conclusion: The present study concluded that maximum cases of total knee replacement were in males and functional outcome was excellent in maximum cases.

The femur forms knee joint at it’s lower end by articulating with tibia and patella, which is a complex synovial joint. It plays a crucial role in weight bearing and undergoes severe wear and tear and age related changes that may require interventional surgeries. Morphometry of distal end of femur is vital for designing prosthesis for knee joint, considering the variations in different ethnic groups. The present study is designed to analyse the morphometric parameters of distal ends of 60 dry non-pathological femur using Vernier calipers. The results were analysed for statistical significance. The data obtained from the present study, when compared with those obtained from studies done on different ethnic population showed difference in measured parameters which must be kept into account while designing prosthesis for population of different countries.

Background: Exercise exerts multifaceted effects on the human body, including potential impacts on cognitive function and psychomotor speed. Existing research suggest that effects on these dimensions is quite ambiguous. Reaction time has emerged as a simple, non-invasive and reliable marker of the speed of sensorimotor integration and processing and even cognitive functions. It has been validated in numerous studies. However, literature on the effect of exercise on reaction time remains inconclusive. This necessitated the present study. Objectives: The study was done with the objective of ascertaining the effect of a short-duration exercise program, comprising both isometric and isotonic contractions, on visual and auditory reaction times in young adults. It also sought to quantify the change observed. Methods: A descriptive, observational study was conducted on 60 healthy young adults. Visual and auditory reaction times were recorded using a multiple-choice reaction time apparatus before and after the exercise session. Exercise intensity was graded based on post-exercise heart rate. The data was analyzed using SPSS. Before-after comparison of mean values was done with paired t-test. Linear regression was used to quantify the change and find out factors which could consistently predict the outcome in terms of percentage of change in the reaction times. Results: Both visual and auditory reaction times significantly decreased after exercise. The average decline in Visual (VRT) and Auditory (ART) Reaction times were approximately 18% and 21% respectively. Baseline reaction times and exercise intensity both were significant predictors for ART and together accounted for 40% of the decrease. In VRT, only baseline values emerged as a significant predictor contributing to 24% of the variance. Conclusion: Short-duration exercise significantly improves psychomotor processing speed, as evidenced by reduced reaction times. Exercise intensity significantly affects the auditory reaction times. This improvement is likely mediated by mechanisms such as enhanced cerebral blood flow, faster neural transmission, and improved cognitive function.

Background: A reliable intraoperative pathological diagnosis is necessary before a proper surgery of breast lesions. Frozen section and imprint cytology are two most important techniques used for intraoperative diagnosis of breast lesions. When frozen section and touch imprint cytology are widely used together, the sensitivity, specificity and diagnostic accuracy can be very well increased. Objectives: This study was conducted in GMKMCH, Salem to evaluate the role of frozen section in diagnosing both benign and malignant breast lesions, to find out the diagnostic accuracy of frozen section in breast lesions by correlating it’s findings with those of touch imprint cytology and Histopathological examination. Materials and Methods: This is a prospective study conducted in the department of pathology in Govt. Mohankumaramangalam medical college, Salem for a period of 2 years from November, 2016 to June 2018 after getting approval from the institutional ethical committee with the inclusion criteria being all patients of both genders of all age groups presenting with breast lesions to the department of surgery and referred to the department of Pathology and exclusion criteria being infective pathology. Both frozen section and touch imprint cytology were done from the breast lesions immediately on the day of surgery. Then the results of both the techniques were correlated with one another keeping paraffin section diagnosis as the gold standard. The data collected were analyzed with IBM.SPSS Statistics software 23.0 Version. Results: In this study, the sensitivity of touch imprint cytology was 93.1 %, specificity was 100 %, positive predictive value was 100%, negative predictive value was 92.3% and accuracy was 96.55%. and the sensitivity , specificity, positive predictive value and negative predictive value of frozen section were 100 % thus proving frozen section is a better technique than touch imprint cytology. Conclusion: In this study, although the results of Touch imprint cytology correlates with frozen section and paraffin section in terms of benignity and malignancy, the ability of imprint cytology in diagnosing individual lesions is inferior to that of frozen section study and paraffin section examinations. Though the frozen section study had some limitations, it was proved to be a highly accurate diagnostic modality with an accuracy rate of 100%. Thus a judicious and proper selection of these diagnostic modalities is essential for proper management of the patients.

Background and aim: Distal Radius fracture is a very commonly encountered fracture in adults. Malunion is very common in such fractures in either neglected, poorly treated by conservative method or even in some surgically managed patients; with restricted functional ability and pain. Corrective osteotomy with fixation is a surgical treatment option in such cases. In our study we evaluated the functional outcome of corrective osteotomy and fixation with volar locked plate without application of bone graft. Methods: An observational study was conducted at Agartala Govt. Medical College during February 2022 to July 2024 including 19 adult patients with malunited extraarticular distal radius fracture with restricted functional ability. All patients were managed surgically by corrective osteotomy and volar locked plating without application of bone graft via Modified Henry Approach. Functional outcome assessment was done using Patient-Rated Wrist Evaluation (PRWE) score and radiological assessment done on Xray of the effected wrist Antero-posterior and Lateral View. Results: Among 19 patients who were included 7 were male & 12 female; mean age 51.8 years. Complete fracture union was seen in 18 patients without any further intervention, only one patient showing nonunion was reoperated and achieved union subsequently. Mean postoperative improvement in flexion was 24.9 degree, extension 22.2 degree, pronation 23.3 degree and supination 23.2 degree, ensuring functional range of motion. Only two patients showed early osteoarthritis. All patients achieved excellent functional outcome by the end of the study; the mean Pre-Operative PRWE score was 55.4 and the Mean Post-Operative PRWE score was 10.7 which is found to be statistically significant. Conclusion: Corrective osteotomy and fixation by distal radius volar locked plate without application of bone graft is an effective, reliable and easily reproducible treatment option for malunited extraarticular distal radius fracture in adults which provides an excellent clinical, radiological and patient related functional outcome with improved grip strength and with minimal complications. This outcome reinforces the utility of this approach in its treatment.

Background: Acute Undifferentiated Febrile Illness (AUFI) is a significant health concern, especially in tropical regions like India, where it poses diagnostic challenges due to its nonspecific symptoms. Scrub typhus, caused by Orientia tsutsugamushi, is a common but underdiagnosed infectious disease in these regions, leading to severe complications and high mortality if untreated. Objective: To characterize the clinical, demographic, and molecular features of scrub typhus in southern Rajasthan, India, and assess the correlation between laboratory parameters, strain identification and patient outcomes. Material & Methods: A prospective, analytical study was conducted at the Pacific Institute of Medical Sciences, Udaipur, from November 2020 to November 2024. Blood samples from patients with acute febrile illness were tested for scrub typhus using serological (ELISA) and molecular (PCR) diagnostic methods. Clinical features, demographic data, laboratory parameters, strain variability and disease outcome were analyzed. Results: A total of 350 scrub typhus cases were confirmed. The majority of patients (55.71%) were female, with the highest prevalence observed in the 21-50 years age group (68.28%). Rural and tribal backgrounds predominated (86% combined). The most common clinical manifestations were fever (100%), myalgia (98%), headache (88.57%), and rash (75.14%). Eschar was present in 23.71% of cases. Hepatomegaly and splenomegaly were observed in 41.14% and 41.42% of cases, respectively. Laboratory findings included raised liver enzymes (33.14% for SGPT and 32% for SGOT), thrombocytopenia (36.85%), and raised ESR (48%). Complications: Major complications included ARDS (38.28%), Multi-organ Dysfunction Syndrome (MODS) (40.28%), jaundice (31.14%), and acute kidney injury (17.42%). The mortality rate was 14%, with male patients (18.06%) showing higher mortality than females (10.76%). Agricultural workers had the highest mortality (15.83%). Laboratory parameters correlated significantly with mortality, with elevated ESR, urea, creatinine, SGOT, SGPT, and bilirubin levels in deceased patients. Molecular Findings: PCR sequencing revealed the presence of Kato-like genes in 70% of deceased patients and Karp-like genes in 80%. The Gilliam strain was not detected in any sample. Conclusion: Scrub typhus is a significant cause of febrile illness in southern Rajasthan, with high mortality, particularly among males and agricultural workers. Early diagnosis, prompt treatment, and management of complications are crucial for improving patient outcomes. Molecular studies reveal strain-specific variations that may influence disease severity and outcomes.

Background: Tuberculosis (TB) remains a global health challenge, with multidrug-resistant tuberculosis (MDR-TB) emerging as a major concern. Early and accurate detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance is crucial for effective treatment and control of TB. This study aimed to compare the diagnostic utility of Ziehl-Neelsen (ZN) smear microscopy and GeneXpert MTB/RIF, a rapid molecular test, in detecting MTB and rifampicin resistance. Methods: A total of 1,959 clinical samples (including sputum, bronchial alveolar lavage, CSF, pleural fluid, pus, lymph node aspirates, and other extrapulmonary specimens) were processed from January 2024 to December 2024 at Pacific Institute of Medical Sciences, Udaipur. Samples were analyzed using both ZN smear microscopy and the GeneXpert MTB/RIF assay for the detection of MTB and rifampicin resistance. Results: Among the 1,959 samples, 389 (19.85%) tested positive for acid-fast bacilli (AFB) using ZN staining, while 475 (24.25%) tested positive by GeneXpert. Rifampicin resistance was detected in 16 samples (0.81%). The highest rifampicin resistance was found in sputum samples (0.62%). GeneXpert identified MTB in 6.43% of smear-negative samples, with 5 of them being rifampicin-resistant. GeneXpert showed higher sensitivity and specificity compared to ZN smear microscopy, especially in smear-negative and extrapulmonary TB cases. Conclusion: The GeneXpert MTB/RIF assay offers a reliable and rapid diagnostic solution for detecting MTB and rifampicin resistance, surpassing the limitations of ZN smear microscopy. Incorporating this molecular diagnostic method into routine laboratory practices will significantly improve the detection of drug-resistant TB, facilitating better treatment outcomes and the containment of MDR-TB.

Background: Even though minimal invasive techniques (Laparoscopy) are prevalent in treating or diagnosing acute abdominal surgical emergencies or Non-specific Abdominal Pain (NSAP), but their adoption as a routine procedure has been slower compared to elective procedures. It is due to concerns about inadvertent injuries and longer operative times. Laparoscopy has proven to be a safe and effective diagnostic tool for patients with unexplained abdominal pain. For conditions like appendicitis, perforated peptic ulcers and Cholecystitis, minimally invasive surgery is now considered the preferred approach. In trauma cases, laparoscopy has demonstrated utility and may eliminate the need for laparotomy in certain situations. Aim of the Study: To examine the diagnostic and therapeutic role of early laparoscopy in the management of acute abdominal surgical emergencies or Non-specific Abdominal Pain (NSAP). Materials: The study involved 57 patients admitted with acute abdominal emergencies clinically presenting with pain in the abdomen supportive laboratory and radiological investigations. They were randomly divided in to two groups: Group A (29 patients): In this early Laparoscopy was done within 18 hours. In Group B (28 patients):  clinical Observation and Lab reports follow up done for 48 hours followed by Laparoscopy after 48 hours in the patients with persistent situation. Data were collected on postoperative hospital stay, laparoscopy-related complications, hospital readmissions, final diagnoses, and response rates. Results: The mean patient age was 28.14±09.20 years, with a male-to-female ratio of 1:85:1. 39/57 (68.42%) patients were aged between 20 and 35 years. The most common presenting symptoms were abdominal pain, nausea, and vomiting. Laparoscopic findings revealed appendicitis in 20/57 (35.08%), gynecological pathologies in 18/57 (31.57%) and intestinal obstruction due to bands and adhesions in (24.56%) patients, Blunt trauma to GIT, spleen and liver and penetrating trauma were noted in 05/57 (08.77%) patients. In Group ‘A’ patients had low radiation exposure than in Group B patients (p-0.021) which was significant noted. Diminishing VAS scores of pain on the 1^st, 3^rd and 7^th days was noted in Group B (p-0.001) which was significant noted. Consumption of analgesics was significant in both the group A and B (p-0.001) and Nil analgesics (p<0.01), and nil-by-mouth status (p- 0.01). In Group A patients Hospital stay was shorter with p value less than 0.001, in comparison to Group B patients it was extended stay (p value <0.05) The overall definitive diagnosis was achieved in 27/29 (93.10%) of cases in Group A patients and 22/28 (78.57%) in Group B. Conclusion: Early laparoscopy intervention proved to be significantly effective in managing acute emergencies of the abdomen. The procedure provided a superior diagnostic accuracy to the surgeon, facilitated early discharge, and reduced the chances of not indicated laparotomy procedures.

Background: Neonatal hyperbilirubinemia, or neonatal jaundice, results from elevated bilirubin due to immature liver function and rapid red blood cell breakdown. It affects 60% of full-term and 80% of preterm infants, manifesting as yellowish discoloration of skin and eyes. Classification includes physiologic, breastfeeding, breastmilk, and pathologic jaundice. High bilirubin levels risk kernicterus and brain damage. Diagnosis relies on bilirubin assessment, with phototherapy as the first-line treatment. Though effective, phototherapy may cause mild side effects, including rare cases of hypocalcemia, especially in preterm infants. Objective: This study evaluates serum electrolyte and calcium changes, including hypocalcemia, in neonates with hyperbilirubinemia before and after phototherapy. Design: A Hospital based observational study. Setting:  Department of Paediatrics, Jhalawar Medical College, Jhalawar. Participants: Neonates admitted in Neonatal Intensive Care Unit in SHKBM Hospital receiving phototherapy for neonatal hyperbilirubinemia without any comorbidities. Results:   In this study, 57.9% of neonates were male, with a male-to-female ratio of 1.375:1. Low birth weight was observed in 32.2% of neonates, and preterm births accounted for 24%. Phototherapy significantly reduced bilirubin, sodium, and calcium levels (p<0.001), with hyponatremia (15%) and hypocalcemia (38.3%) increasing after >48 hours of phototherapy. Potassium and chloride changes were non-significant. Conclusions Neonatal hyperbilirubinemia requires prompt treatment to prevent complications. Phototherapy is effective for reducing bilirubin levels but should be used cautiously, considering its risks and benefits. Further research on its safety is needed.

Background: Beta-thalassemia itself is an inherited disorder associated with beta-globin production deficiency. In this case affected children often require an urgent need of regular blood transfusion often results in secondary bone-related complications and iron overload. Regarding bone turnover, calcium itself is an important factor. Among thalassemia patients, their levels are typically below. Methods: A cross-sectional study has been conducted among 65 thalassemia major patients of 5 to 15 years of age. The study duration was from September 2018 to July 2019. The main target was to estimate the levels of serum alkaline phosphatase (ALP) and calcium among patients with beta-thalassemia major and their correlative action regarding the frequency and duration of transfusion itself. Results: There is a high incidence of hypocalcemia (98%) in beta-thalassemia patients. The calcium levels are decreased with association of significant rise in frequency and duration of transfusion. The parameters and transfusion did not show any significant correlation with serum levels of calcium. Levels of ALP were seen to be within normal limits in most of the patients. Conclusions: Since the aforementioned study shows prolonged transfusion as one of the criteria in the patients associated with beta-thalassemia, estimation of levels of calcium should be regularly checked among these subjects, and steps to improve homeostasis of calcium may also be required to avoid various complications.

This current review explains the complex relationship between gut microbiota and metabolic syndrome, focusing on the significant role of gut microbiota along with genetics, and environmental factors in the pathogenesis of the metabolic syndrome. This microbiota with beneficial bacteria plays a pivotal role in the balance of metabolic health by supporting gut barrier integrity, immune function, and the production of short-chain fatty acids (SCFAs), which regulate glucose and lipid metabolism. Any imbalance in the delicate relationship between gut bacteria and the host’s immune system increases the gut permeability and drives chronic inflammation. This leads to Insulin resistance characteristic of metabolic syndrome, which promotes pro-inflammatory adipokines thereby significantly raising the risk of cardiovascular diseases and type 2 diabetes. Host genetics, specifically genetic variations in NOD2 and FUT2 can influence both microbial populations and metabolic consequences. Lifestyle also increases the likelihood of developing metabolic syndrome particularly with diets rich in refined sugars and fats, exacerbating dysbiosis. This study demonstrates the addition of gut microbiota based therapeutic strategies in animal and human studies, including probiotics, prebiotics, and fecal microbiota transplantation (FMT), all of which have demonstrated promising results in lowering inflammation and re-establishing microbial balance . It also focuses on diet modifications like Mediterranean diet can enhance metabolic health and encourage microbial diversity. Considering all of the above, this review article focuses on the requirement of personalized microbiome-focused strategies in preventing and treating metabolic syndrome .Further research works are required on microbiome targeted therapies and their usage clinically.

Background: The lipid profile consisting of lipoprotein and triglyceride (TG) concentration reflects lipid metabolism that is modulated by genetic and environmental factors. The value of lipid profile parameters like TC, TG, LDL, HDL alters in dyslipidemia which can be due to some intrinsic & extrinsic factors, physical inactivity, genetic predisposition or the combination of aforesaid factors. Myeloperoxidase (MPO), a product of systemic inflammation plays important role both in the process of oxidative stress and inflammation and promotes oxidation of lipoproteins. Atherogenic index of plasma (AIP) is defined as the logarithm of the ratio of plasma triglyceride concentration to the HDL concentration. (AI= log TG/HD). It is based on TG and HDL concentrations, both of which are independent risk factors for CAD. [7] Recently, AIP is used as a predictor of atherosclerosis. Objectives: This study was done to find out the myeloperoxidase and paraoxonase1 activity and the association between athrogenic index with Paraoxonase1 activity in dyslipidemic individuals in a population attending tertiary care hospital in eastern India. Methods: Dyslipidemic patients attending the Department of Biochemistry for measurement of Serum lipid profile & belonging to the working age group of 20 – 60 years were included in the study. Patients were identified to be dyslipidemics based on National Cholesterol Education Programme (NCEP) guidelines. The sample size for the study was calculated using Open Epi (Version-3) software and was found to be 280 (140dyslipidemics&140 non dyslipidemics) Serum HDL, LDL were measured by automated analyser using ERBA XL 640 system pack reagents. The calculation of atherogenic index was performed by the formula log₁₀ (Triglyceride/HDL) for each dyslipidemic individuals (atherogenic index1) Estimation of serum myeloperoxidase activity was done by using standardized kit (Elabscience) Myeloperoxidase activity assay kit. Results: The aim of the present study was to compare the Paraoxonase 1 (PON1) and Myeloperoxidase (MPO) activity in dyslipidemic and non dyslipidemic individuals and to find the ratio of MPO and PON1 activities in serum of both the study groups and the correlation of MPO/PON1 and the atherogenic index of plasma (AIP). Statistically significant differences (p<0.05) had been found between dyslipidemics and non dyslipidemics in LDL, HDL, MPO, PON1, MPO/PON1 ratio and the atherogenic index of plasma in our study In our study there was significantly decreased PON1(Z value +10.6, p value <0.05) level and increased level of AIP ( Z value -0.06, p value <0.001)in dyslipidemics in comparison to non dyslipidemics. Conclusions: Therefore, it may be safely concluded that low levels of PON1 activity and high level of MPO activity may be associated with high cardiovascular risks. In future, the cardiovascular risk may be predicted by estimation of these parameters in the serum.

Introduction: Mitral stenosis (MS) is a progressive valvular disease that significantly affects the right ventricular (RV) function. RV strain, assessed using speckle-tracking echocardiography, has emerged as a sensitive marker for evaluating RV dysfunction. This study aimed to evaluate the role of RV strain as a marker of disease severity in MS and its implications in pregnant and non-pregnant patients for guiding early treatment. Methods: This prospective observational study included 60 patients with moderate to severe MS, including 24 pregnant women. Patients underwent detailed echocardiographic evaluations including RV strain, TAPSE, and fractional area change (FAC), RV tissue Doppler. RV strain abnormalities were categorized and correlated with MS severity and outcome. Results: Abnormal RV strain was observed in 63.3% of the patients and 54.2% of the pregnant women. Patients with severe MS had significantly impaired RV strain compared with those with moderate MS (p < 0.001). Post-BMV and RV strain values improved significantly, highlighting their role in monitoring the treatment response. Conventional parameters, such as TAPSE and FAC, RV tissue Doppler remained normal in all patients, underscoring the superior sensitivity of RV strain in detecting subclinical RV dysfunction. Conclusion: RV strain is a cost-effective, non-invasive marker for the early detection of RV dysfunction in MS. It provides valuable insights into disease severity and treatment response, particularly in high-risk groups, such as pregnant women. Integrating RV strains into routine evaluation can improve risk stratification and early management.

Background: Dengue is a mosquito-borne viral infection that has become a significant global public health concern, with a wide range of clinical manifestations. It is a leading preventable cause of morbidity and mortality among both children and adults, particularly in tropical and subtropical regions. Early diagnosis is essential for administering appropriate care, which can significantly reduce morbidity. Evaluating both serological and hematological parameters plays a vital role in the diagnosis and prognosis of the disease. Aims and Objectives: To find out correlation between serological and hematological parameter of dengue. Methodology: A study was conducted over six months, from September 2023 to February 2024, Total 646 suspected cases of dengue were included in the study and their hematological and serological profiles were recorded. The study was conducted at the Department of Microbiology, C.U. Shah Medical College and Hospital, Surendranagar, Gujarat. Result: Out of 646 samples, a total of 128 samples were found positive for dengue NS1 antigen, IgM, and IgG antibodies using the Dengue Combo Rapid Test, a qualitative detection method based on rapid chromatographic immunoassay. The most prevalent hematological abnormality observed was thrombocytopenia, affecting 79% of cases, followed by leucopenia in 47% of cases.

Background: Endoscopic variceal ligation (EVL) is a crucial procedure for the primary and secondary prevention of variceal bleeding. The objective of this study was to evaluate the efficacy and tolerability of EVL in the prevention of variceal bleeding. Methods: This was a retrospective, single-center study from March 2023 to December 2024, including all patients who came for EVL in primary or secondary prevention. Results: A total of 100 patients (male/female: 72/28) were included. The mean age of the patients was 39.00±7.14 years (range: 18–70). Portal hypertension was secondary to cirrhosis in 22 patients (22%) and to a non-cirrhotic cause in 78 patients (88%). EVL was indicated for primary and secondary prevention in 5% and 95%, respectively. All patients had received propranolol with a mean daily dose of 108.07±38.52 mg (extremes: 80–160). Eradication of varices was achieved in 58 patients (58%) with an average of 2.02±0.50 sessions (extremes: 1–4) and an average duration of 9.12±1.23 months (extremes: 1–18). Eighteen patients (18%) had variceal bleeding. There was no significant difference between patients with cirrhotic and non-cirrhotic portal hypertension in terms of varices eradication, variceal bleeding. Dysphagia (74%) and retrosternal pain (79%) were the main adverse events after ligation. Conclusion: EVL is an efficient technique to eradicate varices. Its tolerance is good with post-ligation signs that are rapidly regressive.

Bartter syndrome is a rare, salt-wasting tubulopathy with loss-of-function mutations in the ion channels of the thick ascending limb of the loop of Henle cause renal salt wasting, resulting in hypokalemia, hypochloremia, and hypercalciuria. It is an autosomal recessive disorder that affects one in 1,000,000 people. Clinical manifestations vary in severity and range from polyhydramnios and hypovolemia in the antenatal variant to polyuria and fatigue in the adolescent or adult-onset variant. It results from mutations in several genes, including KCNJ1, CLCNKB, CLCNKA, BSND, and ROMK, which encode ion transporters. We report a rare presentation of adult-onset Bartter syndrome. A 32-year-old man presented to the hospital with bilateral upper and lower limb weakness since 4 days. Patient also had complain of twitching and perioral numbness of face and polyuria. On presentation power in all 4 limbs were reduced, he was normotensive, His serum electrolytes revealed hypokalemia, hypocalcemia , hypomagnesemia ,urine analysis suggestive of raised urinary chloride, raised urinary potassium to creatinine ratio & raised 24 hour urinary calcium. ABG revealed metabolic alkalosis. Bartter syndrome was suspected based on serum and urinary electrolytes assessment and arterial blood gas analysis. The patient was initiated on potassium chloride (KCL) infusion and potassium chloride syrup to correct hypokalemia, calcium correction was given to correct hypocalcemia, indomethacin and spironolactone was started to prevent recurrent loss of potassium followed by which patient’s symptoms resolved completely.

Background: Antidepressants and anxiolytics are commonly prescribed medications among clinicians, reflecting both their professional knowledge and personal coping strategies. Understanding patterns and attitudes toward their use can provide insight into mental health trends and barriers to seeking help. Objective: To assess patterns of and attitudes toward antidepressant and anxiolytic use among clinicians and identify factors influencing their use. Methods: An online survey with a sample size of 200 clinicians was conducted. Data on demographics, medication use, attitudes, and perceived stigma were collected and analyzed using descriptive and inferential statistics. Results: Of the respondents, 38% reported using antidepressants, 42% reported using anxiolytics, and 26% reported using both. A significant proportion (62%) cited stigma as a barrier to seeking treatment. Factors such as age, specialty, and prior mental health diagnoses were significantly associated with medication use patterns. Conclusion: Despite high levels of knowledge about mental health, clinicians face barriers such as stigma in seeking treatment. Targeted interventions to normalize mental health care within this population are warranted.

Objective: The study aimed to examine the improvements in anthropometric indicators, such as weight gain and mid-upper arm circumference (MUAC), among children who were treated at the Nutritional Rehabilitation Center (NRC) in the district hospital of Koppal. Methodology: This prospective observational analysis was conducted over 12 months, from January 2024 to December 2024. Children with SAM were identified according to World Health Organization (WHO) guidelines, defined as a weight-for-height Z-score of less than -3 standard deviations (SD) or the presence of nutritional edema. Children with MAM were defined as those with a weight-for-height Z-score between -2 SD and -3 SD. Children with both SAM and MAM diagnoses who were admitted to the NRC and completed the entire nutritional rehabilitation program were included in the study. Data were collected through hospital records, structured interviews with caregivers, and direct anthropometric measurements. Results: In the severe acute malnutrition (SAM) category, a total of 50 children were included. The mean weight of this group was 5.4 ± 0.9 kg, with a mean height of 60.3 ± 3.5 cm and a mean MUAC of 10.4 ± 0.4 cm. These measurements reflect the severe nutritional deficits characteristic of SAM. In the moderate acute malnutrition (MAM) category, which included 165 children, the mean weight was significantly higher at 7.6 ± 1.2 kg. Similarly, the mean height and MUAC were also greater in this group, recorded at 73.2 ± 4.2 cm and 11.8 ± 0.8 cm, respectively. The differences between the two groups were statistically significant for all three parameters, with p-values <0.0001. The substantially lower weight, height, and MUAC in the SAM group emphasize the critical severity of malnutrition in this category. Conclusion: In conclusion, the findings of this study underscore the effectiveness of nutritional interventions implemented at the Nutritional Rehabilitation Center (NRC) in Koppal in addressing malnutrition among children.

Introduction: Endometrial carcinoma is a common gynecological cancer, particularly in developed countries, though it is less prevalent in India (4.3 per 100,000). It predominantly affects women in their 60s to 70s, with cases in those under 35 being rare. Despite its frequency, the prognosis is favorable, with a 10-year survival rate of 75% due to early detection, as most cases are identified at an early stage through symptoms like postmenopausal bleeding. Material and Methods: This study involved 50 patients with suspected endometrial carcinoma, conducted from January 2024 to September 2024. The study group consisted of mainly patients from different parts of Gujarat, neighbouring states of Rajasthan and Madhya Pradesh. The research was carried out in the Department of Radiology at Gujarat Cancer Research Hospital and BJ Medical College in Asarva, Ahmedabad. Results:- (1) Study Overview: 50 patients with endometrial lesions were evaluated using 3T MRI, providing excellent image quality and tumour characterization. (2) Histopathology: Endometrioid adenocarcinoma was the most common type (84%), followed by high-grade serous adenocarcinoma (10%) and other rare types (2% each). (3) Patient Profile: Endometrial carcinoma was most frequent in menopausal women. Peaking in the 5th and 6th decades, with vaginal bleeding as the most common symptom (100%). (4) MRI Accuracy: MRI showed 88.89% accuracy in local tumour staging compared to post-operative histopathology and effectively assessed lymph node involvement. (5) MRI Findings: Tumours typically appeared hypointense on T1W, hyperintense on T2W, and heterogeneously enhanced post-contrast. MRÍ was superior in evaluating myometrial involvement. Conclusion: MRI is having Superior soft-tissue contrast, Multiplanar imaging (axial, coronal, sagittal), Excellent at detecting soft tissue extensions and extraserosal spread with No ionizing radiation and safe for patients with kidney dysfunction or contrast media contraindications As compared to other modalities MRI Offers 83-92% accuracy in staging, making it the preferred imaging technique. Recent improvements in magnetic field strength and coil technology have greatly enhanced MRI’s performance, further solidifying its position as the primary imaging tool for managing endometrial carcinoma.

Background: Spinal neoplasms present a significant diagnostic challenge, manifesting with a spectrum of symptoms that can mimic various spinal pathologies. This study explores the pivotal role of Magnetic Resonance Imaging (MRI) in diagnosing and characterizing spinal tumors. MRI’s exceptional resolution and multiplanar imaging capabilities make it the gold standard for evaluating spinal neoplasms. Methods: comprehensive analysis of 60 patients with suspected spinal lesion, MRI was done to compare tumor characteristics, and discuss the implications for treatment planning and prognosis. Results: study shows distribution of tumours by age and gender, compartmental distribution and tumoral characteristics. Conclusion: Study shows the critical importance of MRI in diagnosing and characterising of spinal tumor.

Introduction: The aim is to introduce flipped classroom as teaching learning method and to assess its effectiveness for Final MBBS students. Methods: The present study was conducted after taking institutional ethical clearance and informed consent of the participants. 150 final MBBS students participated and were divided into two Groups A and B. Two topics were taught to both groups using either FC-assisted self-directed learning (SDL) sessions or online lecture classes. A cross-over of groups was done to prevent any bias. Pretest and posttest scores of all topics were assessed using multiple-choice questions (MCQs) and feedback was taken. Program evaluation was done. Results: There was no significant difference in performance in pretest MCQ examinations between the two groups. Students of both Groups A and B performed significantly better in posttest MCQ examinations as compared to pretest MCQ examinations. However, the posttest results of the FC group were better. 46.40% strongly agree that there will be increased interest in subject by FC method. 47.40% agree that enhancement in learning by FC method. 43.30% agree that FC should be preferred teaching learning method. 40.20% feel there is improved understanding and course satisfaction. 42.30% agree that exam performance will improve by FC method Conclusion: Faculty and students provided positive views in support of the sessions. Students were highly satisfied with the program. The flipped classroom approach proves to be a superior teaching method, promoting better academic outcomes and greater student engagement and satisfaction More than 40% students believe that it is a better teaching tool and will improve their performance. Teacher’s feedback is the same but they fear that too much effort and resources are required in this FC method.