Background: Preeclampsia and intrauterine growth restriction (IUGR) are major causes of maternal and perinatal morbidity, particularly among primigravidas. Early identification of at-risk pregnancies can significantly improve outcomes. Objective: To evaluate the predictive value of second trimester serum β-HCG and uterine artery colour Doppler velocimetry in identifying primigravidas at risk for preeclampsia and IUGR. Methods: A prospective observational study was conducted on 120 primigravidas between 14–20 weeks of gestation. Serum β-HCG levels were measured and uterine artery Doppler was performed to assess pulsatility index (PI) and presence of bilateral notching. Participants were followed until delivery for development of preeclampsia and/or IUGR. Results: Elevated β-HCG levels (≥2.5 MoM) and abnormal Doppler findings were significantly associated with preeclampsia (p<0.001) and IUGR (p<0.001). When combined, these parameters showed a sensitivity of 88.9%, specificity of 91.3%, and negative predictive value of 96.5%. Dual-positive patients had significantly lower gestational age at delivery and neonatal birth weights (p<0.001). Conclusion: Second trimester β-HCG and uterine artery Doppler are valuable, cost-effective tools for predicting preeclampsia and IUGR in primigravidas. Their combined use enhances predictive accuracy and supports early risk-based prenatal care.

Background: Implant-supported and tooth-supported fixed dental prostheses (FPDs) are widely used for the rehabilitation of partial edentulism. However, comparative long-term data on their survival and complication rates remain limited. Aim: To evaluate and compare the 5-year survival rates and associated biological and mechanical complications of implant-supported versus tooth-supported FPDs. Materials and Methods: This retrospective observational study included 120 patients (60 in each group) treated at a tertiary dental center between 2018 and 2023. Patient records were reviewed for prosthesis type, survival status, and incidence of biological and mechanical complications. Statistical analysis included Kaplan-Meier survival curves and Chi-square tests, with p < 0.05 considered significant. Results: The 5-year survival rate was significantly higher for implant-supported FPDs (93.3%) compared to tooth-supported FPDs (85.0%) (p = 0.031). Biological complications such as peri-implantitis occurred in 6.7% of implant cases, while secondary caries and loss of abutment vitality were more prevalent in tooth-supported prostheses. Mechanical complications included screw loosening (implants) and debonding (teeth), with the latter significantly more frequent (p = 0.012). Conclusion: Implant-supported FPDs demonstrate superior long-term survival and lower biological complication rates compared to tooth-supported FPDs, making them a more durable restorative option when clinically feasible.

Background: Snoring in children is often underestimated, yet it may be a clinical marker for underlying sleep-disordered breathing (SDB), with significant neurocognitive and behavioral consequences. Identifying its prevalence and associated risk factors is crucial for early diagnosis and intervention. Objective: To determine the incidence and prevalence of snoring in paediatric patients aged 2–14 years and evaluate its association with demographic and clinical variables. Methods:

This cross-sectional study included 152 children attending a tertiary care hospital. Data were collected using a validated, interviewer-administered sleep questionnaire. Clinical examination assessed for adenotonsillar hypertrophy, and anthropometric data were recorded. Statistical analysis was performed using SPSS v25.0. Results:

The overall prevalence of snoring was 32.9%, with habitual snoring in 17.1%. Snoring was significantly higher in the 6–9 year age group (p = 0.018), overweight/obese children (p = 0.003), and those with adenotonsillar hypertrophy (p < 0.001). Conclusion: Snoring is a common but often overlooked condition in children. Given its association with modifiable risk factors like obesity and adenotonsillar hypertrophy, early screening and management may prevent progression to obstructive sleep apnea and related complications.

Background: The rapid evolution of educational technology has enabled varied modes of delivery for health education, prompting a need to evaluate the effectiveness of online versus in-person modalities, especially among adolescents. Methods: This study employed a randomized controlled trial design to compare the effectiveness of online and in-person health education on adolescent health behaviors. A total of 200 adolescents from various high schools participated, with equal division into online and in-person groups. The study assessed changes in nutrition, physical activity, mental health awareness, and substance use awareness, utilizing chi-square tests for categorical outcomes and t-tests for continuous data. Results: The results indicated that in-person health education significantly outperformed online education in improving nutritional habits, increasing physical activity, and enhancing mental health awareness. Specifically, in-person participants showed greater improvements in daily fruit and vegetable intake, reduced fast food and sugary drink consumption, higher engagement in physical activities, and better management of stress and anxiety levels. Statistically significant differences were noted with p-values less than 0.05 across most measured outcomes, favoring in-person formats. Conclusion: In-person health education remains a more effective approach for promoting healthy behaviors among adolescents compared to online methods. The direct interaction and immediate feedback provided in in-person settings appear crucial for engaging adolescents and influencing behavior change effectively.

Background: Polycystic Ovarian Disease (PCOD) is a common endocrine disorder among women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Thyroid dysfunction, particularly hypothyroidism, has been frequently associated with PCOD, potentially aggravating metabolic and reproductive abnormalities. This study aims to evaluate the prevalence of thyroid dysfunction in patients with PCOD and its clinical implications. Materials and Methods: A cross-sectional study was conducted on 100 female patients diagnosed with PCOD, aged between 18 and 40 years, attending the outpatient department of a tertiary care hospital. Thyroid function tests, including Serum Thyroid-Stimulating Hormone (TSH), Free Thyroxine (FT4), and Free Triiodothyronine (FT3), were measured. Patients were categorized into euthyroid, hypothyroid, and hyperthyroid groups based on established reference ranges. Data analysis was performed using descriptive statistics and the Chi-square test, with a significance level set at p < 0.05. Results: Out of the 100 patients studied, 70% were found to be euthyroid, 25% had subclinical hypothyroidism, 4% had overt hypothyroidism, and 1% exhibited hyperthyroidism. The prevalence of thyroid dysfunction was significantly higher in patients with higher Body Mass Index (BMI) and insulin resistance (p < 0.05). Additionally, menstrual irregularities and infertility were more prevalent in patients with thyroid dysfunction compared to euthyroid patients. Conclusion: Thyroid dysfunction, particularly subclinical hypothyroidism, is prevalent among PCOD patients and may exacerbate metabolic and reproductive abnormalities. Routine screening for thyroid function in PCOD patients is recommended to ensure early detection and management of thyroid dysfunction.

Background: Anterior urethral stricture is defined as a pathological condition in which a fibrous tissue involves the corpus spongiosum resulting in narrowing of urethral caliber. Surgical modality available for the treatment of urethral stricture disease includes urethral dilatation, direct visual internal urethrotomy (DVIU), stent and reconstructive surgical techniques (Single or double stage urethroplasty). In this prospective observational study, we assess the factors affecting surgical outcome of excision and end to end anastomosis for bulbar urethral stricture. Material and Methods: Total of 36 patients of bulbar urethral stricture who underwent excision and end to end anastomosis and who fulfill inclusion criteria were included in the present study. In this mean age of the patients was 41 years. In this total of 36 patients, 23 cases (63.89%) traumatic, 7 cases (19.44%) iatrogenic, 4 cases (11.11%) idiopathic and 2 cases (5.56%) were infectious. Patients who required any postoperative intervention like dilatation or surgery due to recurrence of symptoms were considered as failure. Results: Out of 36 cases in our study, 22 cases accounting for 61.11% were noted to have complete stricture whereas 14 cases were having incomplete stricture. Mean age of the patients in years was 41 (± 11.64). Out of 36 cases in our study, 20 cases have history of previous surgical intervention like dilatation, VIU or anastomotic urethroplasty accounting for 55.56%. Of 36 cases in our study, 28 cases were associated with stricture related comorbidity accounting for 77.78% cases. Average length of stricture in our study was 13.0278 mm (±4.5134). Shortest length of stricture was 5mm whereas longest stricture length is 23mm. Average duration of surgery in our study was 131.25 min (± 25.39). Shortest duration of surgery was 90 min whereas longest duration of surgery was 200 min. Most common postoperative complication in our patient was scrotal pain, catheter related urinary tract infection, epididymo-orchits, erectile dysfunction, decreased ejaculatory force, urinary incontinence. Out of 36 cases in our study, 33 patients fit into the criteria of success group as they do not require any further intervention in the form of VIU, Dilatation or other definitive surgery. Three cases were not symptom free postoperatively and underwent intervention again. Two patients underwent VIU whereas one patient underwent dilatation and hence considered as failure. Conclusion: In our study, Excision and end to end anastomosis for short bulbar urethral stricture has an acceptable success rate of 91.67% with minimal complications. Stricture etiology determines the surgical outcome of the surgery in our study. Recurrence rate was significantly higher in the patients with nontraumatic causes than in the patients with traumatic etiology. Stricture length determines the surgical outcome of the surgery in our study. We consider strictures upto 2 cm to be suitable for EPA. Prior surgical intervention is associated with longer stricture length in our study. However, this did not impact negatively on the outcome of surgery. Patient aged less than 50 years in our study showed better MFR postoperatively than did those aged 50 years or more. Delay in undergoing surgery is common observation in our study, however it further adds on disease associated comorbidity.

Background:  Recovery from Anterior Cruciate Ligament (ACL) reconstruction can be significantly influenced by the type of rehabilitation protocol employed. This study aims to compare the effects of conservative, moderate, and accelerated rehabilitation protocols on recovery outcomes. Methods: A retrospective cohort study was conducted involving 180 patients who underwent ACL reconstruction. Patients were grouped into three rehabilitation protocols: conservative (n=57), moderate (n=62), and accelerated (n=61). Data on time to full weight bearing, functional recovery scores, patient satisfaction, and incidence of reinjuries were collected and analyzed. Results: The accelerated rehabilitation protocol showed a significantly shorter time to full weight bearing (mean 10.6 weeks) compared to the conservative (mean 14.7 weeks) and moderate (mean 12.3 weeks) protocols (P < 0.001). Functional recovery scores were higher in the accelerated group at 1, 3, and 6 months post-surgery, with significant differences noted at each time point (P < 0.001 at 6 months). Patient satisfaction was highest in the accelerated group (mean score 8.9), differing significantly from the conservative group (mean score 8.1, P = 0.022). Reinjury rates within 12 months post-surgery were lowest in the accelerated group (7.6%), compared to conservative (16.4%) and moderate (11.3%) groups (P = 0.033). Conclusion: Accelerated rehabilitation protocols appear to enhance recovery outcomes post-ACL reconstruction, with faster return to full weight bearing, higher functional recovery scores, increased patient satisfaction, and lower reinjury rates. These findings suggest that accelerated protocols may be more effective for certain patient demographics and should be considered in clinical practice.

Background: Developmental anomalies of the thyroid gland are significant contributors to pediatric morbidity, with varying prevalence and impacts based on geographical and genetic factors. Understanding these anomalies is crucial for early intervention and management to prevent long-term developmental complications. Methods: This cross-sectional study was conducted on a cohort of 160 newborns screened for thyroid anomalies as part of their routine newborn screening process. The study assessed the prevalence and types of thyroid developmental anomalies, using measurements of thyroid-stimulating hormone (TSH) and thyroxine (T4) levels, supplemented by ultrasound examinations. The association between thyroid anomalies and early developmental outcomes was also evaluated. Results: Of the 160 newborns, 26 (16.25%) were found to have thyroid developmental anomalies. The most common anomalies identified were thyroid dysgenesis (8.75%) and ectopic thyroid tissue (7.5%). Less frequently observed was dyshormonogenic goiter (3.75%). Statistical analysis revealed significant associations between specific thyroid anomalies and developmental outcomes, such as cognitive delays associated with ectopic thyroid tissue (P=0.038) and growth delays associated with thyroid dysgenesis (P=0.047). Conclusion: The study highlights a notable prevalence of thyroid developmental anomalies among newborns, with significant associations to critical developmental outcomes. These findings emphasize the need for robust newborn screening programs to facilitate early detection and timely intervention, potentially mitigating adverse developmental impacts.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a distinct and clinically significant strain of Staphylococcus aureus, responsible for a wide range of infections, from mild skin and soft tissue infections to severe conditions such as pneumonia, bacteraemia, and endocarditis. Aim: To study the resistance patterns of Clindamycin in Methicillin resistant Staphylococcus aureus by D test and its relation to minimum inhibitory concentration by broth microdilution method. Objectives: To isolate and identify methicillin resistant Staphylococcus aureus in exudate samples To detect the resistance patterns of Clindamycin in MRSA by D test To determine Minimum inhibitory concentration (MIC) by broth micro-dilution method. Materials and Methods: The prospective study was conducted in the Department of Microbiology, GMC, Ongole, for a period of 6 months. Staphylococcus aureus was isolated from exudate samples by standard microbiological methods. Antibiotic sensitivity test was done by Kirby Bauer disc diffusion technique. MRSA was determined with Cefoxitin (30 µg) disc by Cefoxitin disc diffusion method. Phenotypic detection of various resistance patterns of Clindamycin was done by D test. Minimum inhibitory concentration (MIC) of Clindamycin was studied by broth microdilution method as per CLSI and EUCAST guidelines. Results: Out of 350 exudate samples, 220 were culture positive and 130 were culture sterile. Out of 220 culture positive samples, 120 were Staphylococcus aureus of which 72 were MRSA. Out of the 72 MRSA, 49 were sensitive to both Clindamycin and Erythromycin (non inducible resistance). Of the remaining 23, 14 were D test positive indicating inducible resistance (iMLSB), 7 showed resistance to both Clindamycin and Erythromycin signifying constitutive resistance(cMLSB) and 2 showed resistance to Erythromycin and sensitivity to Clindamycin without D zone indicating possible efflux mechanism. Non-inducible strains showed MIC of ≤0.5 µg/mL. Of the 14 strains with inducible clindamycin resistance, 12 had MICs ≤2 µg/mL, and 2 had MICs ≥4 µg/mL. Strains with constitutive resistance showed MIC of ≥128 µg/mL, while those with a suspected efflux mechanism had MIC ≥4 µg/mL. Conclusions: Detection of inducible resistance by D test among MRSA isolates helps to prevent therapeutic failure with Clindamycin and determining the MIC value can help in predicting the efficacy of the drug. The present study accentuates the importance of the D-test to be employed in routine antimicrobial susceptibility testing to prevent treatment failure.

Background: Objectives: To evaluate the impact of social media on perceived dental appearance and to determine the correlation between times spent on social media and its impact on perceived dental appearance. Methodology: It was a cross-sectional study based on web-based survey. A surveying tool was developed comprising questions about sociodemographic details, use of social media and its effect on perception of an individual regarding his/ her dental appearance. The number of responses received were 347 in a period of three months. Scores were given to variables of Confidence, depression, participation in social gatherings, being ignored socially and being bullied because of dental appearance. These scores were added and final score was categorized from “less than 0 (<0)” as negative and “Greater than 0 (>0)” as positive impact. Results: Among 347 participants, 38% were males and 62% were females. Regarding perceived dental appearance, social media had positive impact on 310(89.3%) of participants and had negative impact on 37(10.7 %) of participants. No correlation was found between time spent on social media and impact on perceived dental appearance with P value statistically non-significant.(P value: 0.477) Conclusion: Majority of participants reported to have a positive impact of social media on perceived dental appearance. No statistically significant association was found between time spent on social media and its impact on perceived dental appearance.

Background: Weaning refers to the shift from ventilator support to totally spontaneous breathing, during which the patient bears responsia bility for efficient gas exchange while positive support is stopped. Weaning patients after a time of ventilation is a challenge for intensivists and respiratory care staff, and commencing a spontaneous breathing trial (SBT) is the simplest intervention to determine readiness for extubation. Spontaneous Breathing Trial on a T-piece or a combination of pressure support (PS) and continuous positive airway pressure (CPAP) are the most often employed therapies. The spontaneous breathing trial (SBT) evaluates a patient's capacity to breathe with minimal or no assistance from a ventilator Aim: of the study was to compare the extubation outcome of two weaning methods i.e., CPAP and T-piece trial for extubation in mechanically ventilated patients in pediatric ICU. Material Methods-Study Setting: The study was conducted in Department of Paediatric, CIMSH, Lucknow  from may 2022-April 2023• Study Design: Prospective observational study INCLUSION CRITERIA PICU admission age 1 month to 12 years ▪ Invasive mechanical ventilation for more than 24 hours ▪ Patients/guardians were giving written informed consent. EXCLUSION CRITERIA ▪ Patient not giving consent. ▪ Weight less than 5 kg Died without weaning trial ▪ Tracheostomy ▪ Unplanned extubation ▪ Patients intubated for more than 14 days

Ethical approval was taken from the Institutional Ethics Committee of the university.no.558/Ethics /2022. Result: study was performed in the Department of Paediatrics, Career institute of medical sciences, Lucknow. Post taking ethical clearance from the institutional ethical committee and written informed consent from the guardians, 160 paediatric patients of age 1month to 12 years, admitted in the PICU and receiving invasive mechanical ventilation for more than 24 hours were enrolled for our study. Further, based on the weaning methods the total enrolled patients were randomly sub-divided into 2 groups CPAP [Continuous Positive Airway Pressure (n=80)] & T piece (n=80). Based on the findings of our study we may suggest that, while comparing the results of extubation using CPAP and to those using a T piece as a method of SBT, there was no significant different was found. Conclusion: Our study’s findings presented that in CPAP and T piece both the groups' majority of patients passed the adequate range of S.B.T. Only 7.50% of patients in CPAP and 3.75% of patients in T piece group failed to do so.

Background: Doppler ultrasonography is a crucial tool in assessing fetal well-being, particularly in high-risk pregnancies. The ductus venosus pulsatility index (PI) is commonly used to evaluate fetal circulation and predict adverse pregnancy outcomes, including intrauterine growth restriction (IUGR), preterm birth, and fetal distress. Aim: This study aimed to evaluate the role of ductus venosus PI in predicting pregnancy outcomes in a cohort of 70 pregnant women, assessing its potential as a non-invasive early marker of fetal compromise. Material and Methods: A prospective cohort study was conducted from January 2023 to July 2023. The PI and systolic-to-diastolic (S/a) ratio were measured using Doppler ultrasonography, and pregnancy outcomes were tracked. Data were analyzed to compare these parameters between normal and abnormal pregnancy outcomes. Results: The results showed significant differences in the PI and S/a ratio between the normal and abnormal groups, with abnormal outcomes associated with lower PI values. The sensitivity and specificity of the ductus venosus Doppler in predicting adverse outcomes were found to be high. Conclusion: Ductus venosus PI is a promising non-invasive tool for early detection of pregnancies at risk for complications. Early identification allows for timely intervention, improving maternal and fetal health outcomes.

Background: Hypertension is one of the leading causes of the global burden of disease in the world. Since the incidence of hypertensive patients have increased tremendously, WHO has made it one of its global targets for prevention of non-communicable diseases. Modifiable risk factors for hypertension include unhealthy diets, physical inactivity, consumption of tobacco and alcohol, and being overweight or obese, however Obesity and weight gain are strong independent risk factors for hypertension. Apart from these modifiable risk factors, non-modifiable risk factors such as age, gender, ethnicity 5 and certain genetic factors have also been implicated. Many studies have suggested that there are association of ABO blood groups with various communicable and non-communicable diseases including cardiovascular diseases. Aims and objectives: to ascertain an association between ABO blood group and blood pressure among the undergraduate students in Silchar Medical College & Hospital. Materials and Methods: This cross-sectional study was conducted among 360 medical students during the period of October 2023 to September 2024. The blood pressure was measured by mercury sphygmomanometer and the blood grouping was done by the slide method. The data collected was compiled using Microsoft Excel and analysed using the software SPSS.  A p-value of <0.05 was considered statistically significant. Result:  Regarding systollic blood pressure, Group A has the highest percentage of prehypertension(42.86%) and Group O and Group B has the highest percentage (31.34% and 31.37%) of Stage 1 hypertension with group A has minimum percentage (7.14%). Stage 2 hypertension (systolllic) was seen maximum in AB blood group (14.29%). The chi-square statistic is 15.088 with Degrees of Freedom: 9. The p-value is 0.0885. The result is thus not statistically significant at p < .05. Similarly regarding diastollic blood pressure, Group B has the highest percentage of prehypertension(43.14%) and Group AB has the highest percentage (14.29%) of Stage 1 hypertension while group B has minimum percentage (0.00%). Stage 2 hypertension (diastollic) was seen maximum in B blood group (3.92%). This variation of diastolic BP among the different blood groups was found to be statistically significant. Conclusion: most common blood group among students is Blood group O and the least common is AB. Blood group B individuals have a statistically significant inclination towards obesity and the development of both pre-hypertension and hypertension (Diastolic). However, systolic hypertension among the students did not have a statistically significant variation among the different ABO blood groups.

Background: Humeral nonunion is an uncommon yet challenging complication following diaphyseal fractures, with reported incidence rates ranging from 1% to 10%. Surgical management typically involves fracture site debridement, stabilization using plating, interlocking nailing, or external fixation, and bone grafting to enhance union. In osteoporotic patients, achieving stable fixation can be difficult due to poor bone quality. This study evaluates the efficacy of an intramedullary fibular strut graft combined with dynamic compression plate (DCP) fixation in the management of humeral shaft nonunion in osteoporotic patients. Methods: Twelve patients with osteoporotic humeral nonunion were treated between 2021 and 2023 using a combination of an intramedullary fibular strut graft and DCP fixation. The inclusion criteria were nonunion persisting for a minimum of four months with severe osteoporosis. Patients with significant soft-tissue scarring or vascular compromise were excluded. Clinical and radiological assessments were performed at regular follow-ups to evaluate fracture healing, functional outcomes, and complications. Results: All patients achieved radiological union within three months postoperatively. The mean time from injury to surgery was 12.22 months (range: 6–27 months). The mean preoperative Disabilities of the Arm, Shoulder, and Hand (DASH) score was 83±6, which improved to 29±14 at final follow-up. There was an average arm shortening of 1.61±1.2 cm. None of the patients had implant failure, fibular graft resorption, or nonunion recurrence. Minor complications included superficial wound infections in two patients, which resolved with oral antibiotics, and transient peroneal nerve palsy in one patient. Conclusion: The use of an intramedullary fibular strut graft in conjunction with dynamic compression plating is a simple, cost-effective, and biomechanically stable technique for treating humeral nonunion in osteoporotic patients. It provides immediate mechanical support, enhances fracture stability, and eliminates the need for additional cancellous bone grafting. Given the favorable outcomes observed in this study, this approach may be a valuable alternative for managing humeral nonunion in resource-limited settings.

Background: Minimally invasive surgical (MIS) techniques have revolutionized the treatment of lumbar spinal stenosis (LSS), offering reduced tissue trauma, faster recovery, and improved patient outcomes compared to traditional open surgery. LSS, a common degenerative condition, leads to neurogenic claudication and significant functional impairment. This study evaluates the efficacy, safety, and outcomes of the MIS technique for managing LSS. Methods: This study included 24 consecutive patients who underwent bilateral MicroEndoscopic Tubular Retractor Decompression (METRx). A unilateral approach was used in these patients. A total of 36 levels were decompressed in these patients. These procedures were performed on an outpatient or inpatient basis based on the condition of the patients, under general anesthesia.  Preoperative VAS were recorded and kept as a baseline for comparison. Postoperatively the same VAS were recorded at 2, 6, 12, 26, and 52 weeks. The patient's satisfaction was recorded by using the PhDx Patient Satisfaction Questionnaire (Albuquerque, NM, USA). Results: The study included 24 patients (15 females, 9 males) with a mean age of 66.5 years. A total of 36 levels were decompressed, with L4/5 being the most common site (19 cases). The mean duration of symptoms was 38.55 months. Postoperatively, VAS scores showed a statistically significant reduction in pain from 12 weeks onwards, reaching 2.83 at 52 weeks (p=0.001). Patient satisfaction improved significantly, stabilizing after 26 weeks. Analgesic use declined postoperatively, with opioids being the most common. The overall complication rate was 16.7%, with infection (8.3%) being the most frequent. MIS demonstrated sustained pain relief and patient satisfaction. Conclusion: The current study found that the MIS technique for LSS provides significant pain relief and acceptable patient satisfaction and has a good safety profile. The gradual improvement in the symptoms suggests that patients need to be counseled that maximum benefits could take 3 – 6 months. The complication rates of MIS were better then what is reported with open techniques. There is a slightly higher rate of infection could be important in cases of pre-existing comorbidities. These findings support MIS decompression as an effective treatment option for appropriately selected LSS patients.

Background: Introduction: Polytrauma has been described as a syndrome of multiple severe injuries (Injury Severity Score [ISS] ≥17) and systemic inflammatory response syndrome (SIRS) for a minimum of one day, which may culminate in organ dysfunction or failure. In occult states of hypoperfusion, anaerobic metabolism is prevalent, with consequent augmentation of lactate production and lactic acidosis. Lactic acidosis that is persistent can cause respiratory failure, multiple organ dysfunction syndrome (MODS), or death. Among the multiple clinical parameters, serum lactate concentration is regarded as a significant marker of insufficiency of tissue oxygenation and is closely related to poor outcomes in trauma victims. Materials and Methods: A one-year prospective observational and analytical study was performed at Assam Medical College and Hospital from March 2023 to February 2024 in 81 polytrauma patients admitted to the emergency ward. Serum lactate levels were recorded at admission, and lactate clearance was measured within 24 hours. The association between lactate parameters and clinical outcomes was studied. Results: Serum lactate levels and lactate clearance during the initial 24 hours were significantly related to patient outcomes. Early recovering patients had a mean admission lactate of 30.52 mg/dl and lactate clearance of 18.49%, while those who died had a mean admission lactate of 82.55 mg/dl. Conclusion: Admission serum lactate and early lactate clearance are reliable predictors of prognosis in patients, risk of developing complications, intensive care requirements, and chances of survival. The parameters can be used to guide clinical decision making in resuscitation, monitoring, and reconstructive surgery timing in polytrauma patients.

Background: Acute appendicitis accounts for one of the most common conditions that demands emergency surgery.[1] Suspected acute appendicitis cases were operated, on histopathological examination revealed a more serious underlying pathology. Hence, histopathological evaluation forms gold standard for diagnosis of appendicular lesions. Aim: To study spectrum of histopathologic diagnosis in all the appendicectomy specimens received in view of better management and to estimate the incidence of unusual findings affecting the patients morbidity and mortality. Materials and Method: This is a retrospective study of 430 appendicectomy specimen received in histopathology department of tertiary health care center during a period of 24 months. Data was collected from appendicectomy specimens diagnosed by H&E staining and immunohistochemistry whenever needed in histopathology department of tertiary health care center. Data obtained were studied to determine various histopathological patterns in appendicectomy specimens. Results: A total of 430 specimens were analyzed. 238 (55.35%) were males and 91(44.65%) were females. The histopathological examination showed Acute appendicitis (44.42%), Acute suppurative appendicitis (25.35%), Chronic appendicitis (18.83%), Perforated appendicitis (1.3%), Eosinophilic appendicitis (0.7%), Tubercular appendicitis (0.7%), Adenocarcinoma of appendix (0.93%), Well differentiated neuroendocrine Tumor of Appendix (0.23%). Conclusion: Most of the cases in this study were diagnosed with non-neoplastic diseases of appendix, though a few of them were important incidental neoplastic conditions which were missed preoperatively or intraoperatively. These important incidental diagnoses and with the increasing trend of malignancies globally, there is undisputable necessity for routine histopathological examinations in all appendicectomy specimens.

Background: Despite the universal documentation of USG at the time of 2nd-trimester USG evaluation of fetal anomaly, a detailed appraisal of placental location with exception of placenta previa and its predictability of adverse maternal and neonatal outcome has not been undertaken. Present study was aimed to find the association of placental location and maternal-neonatal outcomes. Material and Methods: Present study was prospective, observational study, conducted in pregnant women more than 28 weeks of gestation, delivered at our institute. Results: Total 400 patients with ultrasound diagnosed case of early pregnancy were enrolled in study. Mean age of patient was 23.98 ± 3.32 years. Majority of placenta were situated anteriorly (35%), followed by placenta situated posteriorly (33%), low lying (13%), at fundus (11%) & laterally (8 %). In present study, majority women undergone vaginal delivery (75.7 %) as compared to women undergone caesarean delivery (24.2 %). Out of 400 cases ,36 cases (9%) had Postpartum Hemorrhage & 6 (1.5%) cases underwent obstetric hysterectomy, maximum were due to placenta accreta spectrum disorders. 2.2% of cases i.e. 9 cases required ICU admission of which 7 cases required ventilatory support and 0.2% cases had mortality. Out of 400 cases, 10 cases were still birth, of which maximum cases (40%) were seen in cases having posterior placentation. The birth weight of baby (p value - 0.016) & the APGAR score of baby at 5 minutes (p value - 0.049) was significantly associated with the placental location. The risk of NICU admission was not associated with the placental location (p value >0.05). Conclusion: Women with Anterior placenta has high risks of Severe preeclampsia, Gestational diabetes mellitus, IUGR, NICU admissions due to perinatal asphyxia.

Background: Laparoscopic cholecystectomy (LC) is the gold standard for gallbladder removal, traditionally performed using a four-port technique. Recent advancements have introduced the two-port LC as a less invasive alternative, promising reduced postoperative pain, shorter hospital stays, and improved cosmesis. This study compares the surgical and cosmetic outcomes of two-port LC versus the standard four-port LC in a tertiary care setting. Methods: This prospective, observational study enrolled 80 patients with symptomatic gallstone disease, randomly assigned to either the two-port LC (n=40) or four-port LC (n=40) group, conducted over 18 months at an urban tertiary care hospital. Patients aged over 18 with cholelithiasis, with or without cholecystitis, were included, while those with prior midline abdominal surgeries, severe systemic diseases, or pregnancy were excluded. Outcomes assessed included operative time, postoperative pain (via Visual Analogue Scale, VAS), analgesic requirements, hospital stay, scar cosmesis (using the Patient and Observer Scar Assessment Scale, POSAS), and complications. Data were analyzed using SPSS version 25, with statistical significance set at p≤0.05. Results: The two-port LC group demonstrated significantly shorter operative time (72.2±10.6 vs. 77.5±12.32 minutes, p=0.04), reduced postoperative pain (VAS scores at 2, 4, 12, 24, and 48 hours, p<0.05), lower analgesic need (1.6 vs. 2.25 doses, p=0.001), shorter hospital stay (3.90 vs. 4.88 days, p=0.001), and better scar cosmesis (POSAS patient score: 15.83 vs. 19.85, p=0.001; observer score: 17.78 vs. 23.45, p=0.002) compared to the four-port group. Conversion rates to four-port or open cholecystectomy, additional port/suture use, and intraoperative complications (e.g., gallbladder perforation, liver bed bleeding) were comparable between groups (p>0.05). No major bile duct or visceral injuries were reported. Conclusion: Two-port LC offers superior surgical and cosmetic outcomes compared to the standard four-port LC, with reduced operative time, postoperative pain, analgesic use, hospital stay, and enhanced cosmesis, without compromising safety. Its feasibility as a daycare procedure, even in acute and chronic cholecystitis, suggests it can be mastered with proper training. However, limitations include a small sample size and short follow-up, warranting larger studies to validate these findings across diverse gallbladder pathologies.

Background and objectives: Pain is a complex subjective experience comprising both physical and emotional components.Breast disease is commonly diagnosed with high incidence of breast cancer and leading cause of cancer related mortality among females. Regional anaesthesia with its opioid- sparing effects is most preferred as it dramatically reduces post-surgical pain and opioid- related side effects. Erector spinae plane block (ESPB) is a popular and relatively newer block, it is simple, safe, easy to perform by ultrasound guidance (USG). Aim: This study aimed to compare the postoperative pain relief provided by ultrasound guided erector spinae block using local anaesthetic 0.25% bupivacaine and intravenous paracetamol infusion in patients undergoing breast surgeries under general anaesthesia. Materials And Methods: In this prospective observational comparative study conducted in Department of Anaesthesia, Akash Institute of Medical Sciences and Research Centre, Devanahalli, Bengaluru, Karnataka, India. This study involved 60 female patients belonging to ASA 1 and 2 undergoing breast surgery under general anaesthesia are divided into two groups, Group A: after surgery and before extubation regional anaesthetic technique,i.e. ESPB was performed; Group B: Intravenous paracetamol infusion with 1gram was given before extubation and the quality of analgesia, time for first recue analgesia and total number of rescue analgesics requirement, pain score (VAS) were compared between the two groups upto 48 hours. Results: The group A (ESPB group) demonstrated significantly better pain relief during the first six hours postoperatively, with lower VAS scores compared to group B (paracetamol group). The requirement for rescue analgesics was markedly lower in the group A (20%) compared to the group B (73.4%). Although there was no significant difference in the time to first rescue analgesic between the groups, the overall consumption of rescue analgesics was significantly higher in the group B (paracetamol group). Hemodynamic parameters and respiratory rates were comparable between the groups. Sedation scores were slightly higher in the group B (paracetamol group) during the first hour postoperatively. Patient satisfaction was significantly higher in group A (ESPB group). Conclusion: Ultrasound-guided ESPB provides superior analgesia compared to intravenous paracetamol in patients undergoing breast surgeries, with fewer rescue analgesic requirements, lower sedation scores, and higher patient satisfaction. These findings suggest that ESPB is an effective and preferable option for postoperative pain management in breast surgery patients.

Background: Ovarian tumors are heterogeneous neoplasms characterized by diverse clinical, morphological, and histological features. Ovarian cancer is the sixth most commonly diagnosed cancer among women globally and causes more deaths annually than any other cancer of the female genital tract. This study aimed to assess the frequency of immunohistochemical expression of p53 across different types of ovarian tumors. Methods: The study included cystectomy, oophorectomy, and total abdominal hysterectomy with salpingo-oophorectomy specimens from histologically confirmed primary ovarian tumors. The specimens were prepared and examined according to standard staining protocols. P53 expression was analysed using immunohistochemical staining of the tumor tissues. Tissue sections underwent paraffin removal, rehydration, and heat-induced epitope retrieval (HIER) for antigen retrieval. Primary p53 antibody staining was followed by treatment with a detection system and secondary antibody. Results: This study included 120 ovarian tumors, with ages ranging from 15 to 87 years. Most cases occurred in the 2nd to 5th decades of life. Benign tumors (78%) were most common in the 21–40 age group, borderline tumors (7%) in the 21–50 age range, and malignant tumors (15%) in those aged 41–60. Surface epithelial tumors (72.5%) were the most frequent, followed by germ cell tumors (21.6%) and sex cord-stromal tumors (5.8%). p53 expression was most prominent in malignant tumors (88.8%), particularly high-grade serous carcinomas, while benign tumors showed no p53 positivity. The most common symptoms were abdominal mass (50%) and pain (33%). Conclusion: Immunohistochemistry is essential for diagnosing certain ovarian tumors with uncertain diagnoses. In this study, immunohistochemical markers were valuable for the accurate diagnosis of high-grade serous carcinoma. Surface epithelial tumors were the most common neoplasms, with mucinous cystadenoma being the most frequent. The ratio of benign to malignant ovarian neoplasms was 5:1. P53 expression was overexpressed in malignant tumors, and the detection of p53 mutations through immunohistochemistry in surface epithelial tumors improves the understanding of the pathogenesis of both low- and high-grade serous carcinomas.

Background Acute coronary syndrome (ACS), encompassing unstable angina and myocardial infarction (MI), remains a leading cause of morbidity and mortality worldwide. C-reactive protein (CRP), an inflammatory marker, has gained attention for its role in predicting cardiovascular events. This study aims to evaluate the prognostic significance of CRP levels in patients with ACS and their correlation with clinical outcomes. Materials and Methods A total of 100 patients diagnosed with ACS were included in this prospective study. Patients were classified into two groups: unstable angina (n=50) and MI (n=50). Serum CRP levels were measured at the time of admission and categorized into low (<3 mg/L), moderate (3–10 mg/L), and high (>10 mg/L) levels. The association of CRP with in-hospital complications, length of hospital stay, and mortality was assessed. Statistical analysis was performed using SPSS, and a p-value of <0.05 was considered significant. Results Patients with higher CRP levels (>10 mg/L) showed a significantly increased risk of major adverse cardiac events (MACE) (p=0.002). The mean CRP level in MI patients was 12.5±4.3 mg/L, significantly higher than in unstable angina patients (6.8±2.7 mg/L, p<0.01). Prolonged hospital stay (>7 days) was observed in 65% of patients with high CRP levels compared to 30% in those with moderate CRP levels. Mortality rates were 12% in the high CRP group, while no deaths were recorded in the low CRP group. Conclusion Elevated CRP levels in ACS patients are associated with worse clinical outcomes, including higher rates of MACE, prolonged hospitalization, and increased mortality. CRP can serve as a valuable biomarker for risk stratification and prognostic evaluation in ACS patients. Further large-scale studies are warranted to validate these findings.

Background: Blood samples sent to clinical Biochemistry Laboratory for analysis of serum electrolytes are exposed to certain preanalytical factors which affect the results and hence affect the clinician's decision towards patient care. Delay in sample analysis due to prolonged transit time of sample from collection centre to laboratory, large sample load, breakdown of analyser, no proper storage facilities of samples are some of the preanalytical variables affecting the serum electrolyte values. In view of high magnitude of safety issues in providing patient care, the current study was undertaken.

Objectives: To establish the effect of clot contact time on serum electrolyte values

To evaluate the variation in serum electrolyte levels on analysis within 1hr of sample collection, at 3 hours and at 24 hours. Methods: 900 samples were collected from IP patients admitted in GGH, Kurnool during 2 months duration from January 2025 to February 2025. The samples were analysed in 24hrs Clinical Biochemistry Laboratory by Indirect Ion selective electrode method in Sensa core ST Pro 200 Electrolyte analyser. Haemolysed, icteric, lipemic samples were excluded in the study due to preanalytical errors. The samples were stored at 4°c and analysed at 1,3 and 24 hrs stipulated time. Paired t-test done on values of serum electrolytes at three different time intervals. Results:  We found significantly (p<0.05) increased serum electrolytes- serum sodium and potassium at 24hrs compared to 6hrs and 1hr respectively. Conclusion: Serum-clot contact time effects the serum electrolyte levels. Prolonged serum-clot contact time falsely increases the serum sodium and potassium. Hence the serum must be separated from the clot within 3hrs of time.

Background: Intermittent fasting during Ramadan involves abstinence from food and fluid intake from dawn to sunset for 29-30 days. While several studies have examined its effects in people with Type 1 Diabetes (T1D) globally, data from the Indian subcontinent, particularly Northern India, is limited. Aim: To evaluate the effects of Ramadan fasting on glycemic control, metabolic parameters, and complications in patients with T1D at a tertiary care center in Uttar Pradesh, India. Material and Methods: This prospective observational study included 50 patients with T1D who intended to fast during Ramadan. Participants were assessed before Ramadan (baseline), during Ramadan (mid-point and end), and 4 weeks after Ramadan. Primary outcomes included frequency of hypoglycemia, hyperglycemia, and diabetic ketoacidosis (DKA). Secondary outcomes included changes in HbA1c, fructosamine, body weight, lipid profile, and insulin requirements. Results: Of the 50 participants (mean age 24.6±7.8 years, 52% male), 37 (74%) completed at least 15 days of fasting. Hypoglycemia episodes increased during Ramadan compared to baseline (0.16 vs. 0.05 episodes/patient/day, p<0.01), with most episodes (76.8%) being mild. Hyperglycemia was more common than hypoglycemia (0.24 vs. 0.16 episodes/patient/day, p<0.05). Two patients (4%) experienced DKA requiring hospitalization. Fructosamine levels decreased significantly during Ramadan (342.6±51.3 vs. 317.2±48.5 μmol/L, p<0.05), while HbA1c showed modest reduction post-Ramadan (8.6±1.4% vs. 8.2±1.3%, p=0.06). Total insulin requirements decreased during Ramadan (0.74±0.18 vs. 0.65±0.16 units/kg/day, p<0.01), with greater reduction in basal insulin. Total cholesterol and LDL-cholesterol increased significantly during Ramadan (p<0.05). Conclusion: Ramadan fasting in patients with T1D is associated with increased risk of hypoglycemia and hyperglycemia, though most episodes were mild. Therapeutic adjustments, structured education, and advanced glucose monitoring can facilitate safer fasting for patients with T1D during Ramadan.

Background: Lymph node lesions form a wide range of spectrum, exhibiting manifestations in both hematopoietic tissue and lympho reticular system. It is necessary to document the same spectrum in a particular region to understand the trend and diseases occurring frequently in that region. The range encompasses benign reactive changes to frank malignant lymphoma and metastatic deposits.histopathology is considered to be the gold standard and its relevance to clinical diagnosis is studied here. Aims:  Histopathological study of soft-tissue tumors in a tertiary Centre. Materials and Methods: Prospective   study done in the department of Pathology at Mamata academy of medical sciences, Bachupally, Hyderabad, Telangana for duration of 6months ie from July 2024 to Dec 2024. Results:  Reactive lymphadenitis was most commonly reported accounting 53.3% followed by Abscess and Chronic nonspecific lymphadenitis 11.1% and Chronic Granulomatous lymphadenitis 6.6%, Hodgkin’s lymphoma and NHL in 4.4% and Metastases in 6.6% Conclusion: The present study highlights the importance of lymph node biopsy and in establishing the cause for lymphadenopathy. In this study maximum number of cases were seen in the age group of 41-50 years and there was a female preponderance. In non – neoplastic lesions, reactive lymphadenitis was common. In neoplastic lesions, metastatic diseases were common followed by Hodgkin lymphomas and Hodgkin lymphomas.

Background:  Reverse domestic violence, where males are victims of spousal abuse, is an understudied phenomenon with profound psychological, behavioral, and social implications. This study aimed to explore the socio-demographic profile, psychological conditions, coping mechanisms, and associated factors in males experiencing reverse domestic violence. Aim:  The study aimed to assess the psychosocial factors, marital challenges, and coping mechanisms in males experiencing reverse domestic violence and related marital issues. Methods: A cross-sectional observational study was conducted on 30 male patients attending a psychiatry outpatient department. Data on socio-demographic characteristics, marital status, partner details, reasons for consultation, coping strategies, and mental health assessments were collected using standardized tools, including the Hamilton Depression Rating Scale (HAM-D), Alcohol Use Disorders Identification Test (AUDIT), and Coping Strategies Checklist (CSCL). Descriptive and comparative analyses were performed to identify trends and associations. Results: The mean age of participants was 35.71 years, with the majority (56.67%) aged between 31-40 years. Most belonged to the upper middle socio-economic class (63.33%) and were in their first marriage (86.67%). Partner conflicts were reported by 43.33%, with marital discord, insomnia, and sexual dysfunction being notable reasons for consultation. Coping strategies revealed that 70% of participants perceived their situation positively, and peer support was utilized by 63.33%. However, 30% had low confidence. Psychiatric evaluations showed that 30% had moderate to severe depression (HAM-D ≥ 8), while AUDIT scores indicated low levels of hazardous alcohol use. Over half (56.67%) reported current psychopathology, and 43.33% exhibited negative behaviors. Conclusion: Reverse domestic violence significantly impacts the mental health and coping mechanisms of male victims. Strengthened mental health support, targeted counseling, and awareness programs are crucial for addressing their unique needs. Future research should focus on larger and more diverse populations to validate these findings and develop tailored interventions.

Background: Vitamin D plays a crucial role in glucose metabolism, insulin sensitivity, and pancreatic beta-cell function. Emerging evidence suggests that vitamin D deficiency is associated with increased insulin resistance, contributing to poor glycemic control in individuals with Type 2 Diabetes Mellitus (T2DM). Despite India’s abundant sunlight, vitamin D deficiency is highly prevalent due to limited sun exposure, dietary inadequacies, and lifestyle changes. Understanding the correlation between vitamin D levels and insulin resistance is essential for optimizing diabetes management and preventive strategies. Materials and Methods: This cross-sectional study was conducted at Shaheed Nirmal Mahto Medical College, Dhanbad, over six months in the Departments of Physiology and Medicine. A total of 156 T2DM patients (aged 35–70 years) were recruited based on American Diabetes Association (ADA) diagnostic criteria. Vitamin D levels were measured using electrochemiluminescence immunoassay (ECLIA), while insulin resistance was assessed using fasting insulin levels and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Glycemic control was evaluated using fasting plasma glucose (FPG), postprandial glucose (PPG), and glycated hemoglobin (HbA1c). Data analysis was performed using SPSS 25.0, with Pearson’s correlation and chi-square tests applied to determine associations, considering p < 0.05 statistically significant. Results: Vitamin D deficiency (<20 ng/mL) was found in 60.9% of participants, while 28.8% had insufficient levels (20–29.9 ng/mL), and only 10.3% had sufficient levels (≥30 ng/mL). There was a strong inverse correlation between vitamin D levels and insulin resistance markers, including fasting insulin (r = -0.42, p < 0.001) and HOMA-IR (r = -0.48, p < 0.001).** Among vitamin D-deficient individuals, 82.1% had HbA1c levels above 7.0%, compared to only 37.5% of those with sufficient vitamin D levels (p < 0.001). Biochemical analysis showed poor glycemic control, with mean FPG (145.6 mg/dL), PPG (198.7 mg/dL), HbA1c (7.8%), and HOMA-IR (3.6), reinforcing the role of vitamin D in metabolic regulation. Conclusion: A high prevalence of vitamin D deficiency was observed among T2DM patients, significantly correlating with increased insulin resistance and poor glycemic control. These findings highlight the need for routine vitamin D screening and potential supplementation as part of comprehensive diabetes management. Addressing vitamin D deficiency could play a pivotal role in improving insulin sensitivity, reducing diabetes complications, and optimizing long-term glycemic outcomes. Future research should explore interventional trials on vitamin D supplementation to confirm its therapeutic potential in T2DM management.

Background: Thyroid lesions present a diagnostic challenge often addressed through biopsy techniques such as Fine Needle Aspiration Cytology (FNAC) and Core Needle Biopsy (CNB). Understanding the efficacy and patient outcomes associated with these methods is crucial for optimizing diagnostic protocols. Objective: To compare the diagnostic accuracy, patient outcomes, complication rates, and procedural acceptability between FNAC and CNB in patients with thyroid lesions. Methods: This retrospective study included 180 patients who underwent either FNAC or CNB for thyroid lesions at a tertiary care center. The primary endpoints were diagnostic accuracy and patient outcomes. Secondary endpoints included complication rates and procedural acceptability. Statistical analysis was conducted using Chi-square tests for categorical data and confidence intervals were calculated to assess differences between the two methods. Results: CNB demonstrated a higher diagnostic accuracy (97.8%) compared to FNAC (94.4%), with a statistically significant difference (P=0.013). Patient outcomes were also significantly better in the CNB group (96.7% vs. 91.1%, P=0.031). Complication rates were low for both methods, though CNB had a slightly higher, but not statistically significant, incidence of hematoma (6.7% vs. 3.3%, P=0.078). Pain was significantly less frequent with CNB (5.6% vs. 16.7%, P=0.001). Furthermore, patient satisfaction and procedural acceptability were significantly higher with CNB (95.6% and 93.3% respectively) compared to FNAC (83.3% and 86.7%, P<0.05 for both). Conclusion: Core Needle Biopsy is superior to Fine Needle Aspiration Cytology in terms of diagnostic accuracy, patient satisfaction, and procedural acceptability, with a comparable safety profile. CNB could be considered as a more effective first-line approach for the biopsy of thyroid lesions.

Background: Spinal sub-dural hemorrhage is known to be a very rare entity. A multitude of etiologies have been associated with spinal subdural hemorrhage including bleeding diatheses, pharmacological anticoagulation, vascular malformations, lumbar puncture, epidural anesthesia and spinal surgery 1,2. Of particular interest, traumatic sub-dural hemorrhage is extremely rare1,2 . Only 14 cases have been reported in literature of traumatic spinal sub-dural hemorrhage (TSSDH) 2. Definitive pathophysiological mechanism remains unclear although theoretical explanations have been proposed2. Due to unclear pathophysiology and rare incidence, universally accepted management guidelines are not available 1,2. We report an interesting 15th overall case of TSDH and only the second case of extensive traumatic sub-dural hemorrhage from dorsal to sacral spine and first case that has been managed with expansive laminoplasty with durotomy for neural decompression and hematoma evacuation.  

Background: The management of gynecological malignancies in tertiary care settings faces numerous challenges, particularly in resource-limited environments. This study evaluates the challenges in managing gynecological cancers and analyzes their patterns in a tertiary care facility. Methods: A retrospective observational study was conducted at ESIC Medical College & PGIMSR, Chennai, analyzing 159 cases of gynecological malignancies from 2019 to 2023. Data regarding clinical presentation, treatment modalities, adherence patterns, and outcomes were collected and analyzed using appropriate statistical methods. Results: The mean age of presentation was 54.3 years, with cervical cancer being the predominant malignancy (40.9%). Advanced-stage presentation was observed in 52.2% of cases. Treatment adherence showed significant association with socioeconomic status (p=0.031) and treatment availability (p=0.012). Full treatment adherence was observed in 51.6% of patients, with higher dropout rates in lower socioeconomic groups. Regular follow-up significantly correlated with improved outcomes (p=0.008). Quality of life outcomes varied significantly between early and advanced stages (p=0.015), with better outcomes observed in early-stage disease and among patients with regular follow-up. Conclusion: The study reveals significant challenges in gynecological cancer management, particularly regarding late presentation and treatment adherence. Socioeconomic factors substantially influence treatment outcomes, emphasizing the need for strengthened screening programs, improved healthcare accessibility, and enhanced support systems in resource-limited settings.

Background: Ropivacaine provides effective spinal anesthesia for lower limb and hip surgeries and has better cardiac tolerance than Bupivacaine. Hyperbaric solutions give more predictable and controlled anesthetic effect in spinal block than isobaric preparation. Methodology: The current study is a Prospective Randomized double blind active controlled parallel group clinical trial, done in patients undergoing urological surgeries under Spinal anesthesia in MGM Medical College & Hospital Aurangabad. Results:  The mean onset of sensory block among patients in Group R (2.89±1.13 mins) was faster than patients in Group B (3.02±0.897mins) with p value=0.570. The mean onset of motor block among patients in Group B (4.76±1.21mins) was faster than patients in Group R(4.95±1.65mins) with p value =0.576) . The mean value for time to attend maximum sensory block in Group R was (14.97±3.55 mins) and Group B was (15.35±2.83 mins). p=0.614.The mean duration of sensory block was prolonged in Group B (171.8±12.1min) than Group R (156.5±11.8 min). p value < 0.001. The mean duration of motor block was prolonged in Group B (207.08±9.93 min) when compared to Group R (189.2±14.5 min). pvalue < 0.001.There was no statistically significant difference in the heart rate between the two groups at various time intervals (p > 0.05). Conclusion: The intrathecal hyperbaric ropivacaine (3ml 0.75%) when compared with hyperbaric bupivacaine (3ml 0.5%) for urological surgeries shows faster recovery from sensory as well as motor block. Other Spinal characteristics like onset of sensory and motor block , maximum height of sensory block and haemodynamic variations were comparable in both drugs at given dosages and concentrations .Thus considering the surgical level of duration 0.75% hyperbaric ropivacaine is an good alternative for 0.5 % bupivaccaine in urological procedures

Background Aims: The comprehensive nature of the Enhanced Recovery After Surgery (ERAS) approach, addressing multiple aspects of peri-operative care, appears to synergistically improve patient outcomes. The primary aim of this study is to compare the efficacy of ERAS protocol with traditional protocol in laparoscopic cholecystectomy surgeries and to assess the efficacy of ERAS postoperative events, length of hospital stay, early mobilization, early oral intake and postoperative pain and complications. Methods: This randomised, prospective study was conducted in 60 patients fulfilling the inclusion criteria posted for elective laparoscopic cholecystectomy under general anaesthesia were randomised in to two groups ERAS GROUP (Group E) and TRADITIONAL GROUP (Group T). Patients in Group E were given carbohydrate loading with 100ml of 25% dextrose with minimum starvation and no bowel preparation were as patients in Group T were prepared according to institutional protocol and rest of protocol in both the groups were followed. Results: The Group E has showed a lower median of systolic blood pressure of 112 mmHg (IQR=17) compared to 133 mmHg (IQR=19) in the Group T. This difference is highly significant (Z=-4.83, p<0.01). Similarly, diastolic blood pressure in the Group E shows a lower median of 71 mmHg (IQR=19) compared to 80 mmHg (IQR=10) in the Group T. This difference is also highly significant (Z=-4.43, p<0.01). The Group E achieved both initial and independent mobilization earlier (median 8 hours) compared to the Group T (median 12 hours), showed a statistically significant difference (p=0.04). The Group E had a median stay of 3days (IQR 1), while the Group T had a median of 7 days (IQR 2) showed statistically significant difference (p=0.051). The Group E demonstrated remarkable effectiveness in preventing common post-operative complications, in contrast, the Group T experienced various complications, most notably in blood pressure regulation and glucose control. Conclusion: The ERAS group demonstrated several significant advantages over the traditional peri-operative care approach in laparoscopic cholecystectomy including better hemodynamic stability, earlier postoperative mobilization, shorter length of stay and a marked reduction in postoperative complications. These benefits were achieved without compromising pain control, as evidenced by similar pain scores and need of rescue analgesia between groups.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder and is a global health problem. It consists of an array of dysfunctions, characterized by hyperglycemia due to insulin resistance (IR), inadequate secretion of insulin, and excessive or inappropriate glucagon secretion. Diabetic patients have 2 to 4 times and 1.5 to 3.6 fold increases in risks of cardiovascular disease (CVD) and mortality, respectively. Aim: This study aimed to assess Lipid Accumulation Product (LAP) index and Triglyceride to glucose (TyG) index in patients with Type 2 Diabetes Mellitus. Materials and methods: A cross-sectional study design was conducted in Department of Biochemistry in association with Department of General Medicine, Akash Institute of Medical Sciences and Research Centre, Devanahalli, Bengaluru, Karnataka, India. After obtaining the Institutional Ethics Committee and informed consent from all the study subjects, a total of 252 subjects were recruited into the study by using simple random sampling method. Out of 252, T2DM subjects were 126 and non-diabetic subjects were 126. Fasting blood samples were collected using proper aseptic precautions. Fluoride tubes were used for glucose estimation and clot activator tubes were used for estimation of urea, creatinine and lipid profile. Samples were allowed to stand for 30 minutes at room temperature, followed by centrifugation at 2000 rpm for 10 minutes to obtain plasma/sera. The obtained plasma/sera sample was used for the estimation of fasting and post-prandial glucose by (GOD-POD method), urea (urease), creatinine (jaffe’s), total cholesterol (cholesterol oxidase/peroxidase), triglycerides (glycerol phosphate oxidase/peroxidase), HDLC (HDLC- Direct) were estimated by using Biochemistry fully auto analyzer. LDLC and VLDLC were calculated by Frieldwald’s formula. BMI was calculated. WC was measured in the horizontal plane at the level of the umbilicus during minimal respiration. Blood pressure was measured in addition to family history and lifestyle parameters. The LAPI was calculated as follows: for men, {WC (cm)-65}×{TG concentration (mmol/L)} and for women, {WC (cm)-58}×{TG concentration (mmol/L)} and TyG index. Statistical Analysis: The data was analyzed by using descriptive statistical analysis, and the results were expressed as mean±SD. Categorical variables were presented as percentages. The difference observed if any in quantitative measurement were tested by applying Mann Whitney U test. Spearman’s rho correlation was applied to correlate LAP index, TyG index with BMI, blood pressure and blood sugar. The p value (p <0.05) was considered as statistically significant. Results: The study results showed significant increase in mean age of 56.2±10.2 years, BMI 28.5±3.5 (kg/m2), waist circumference 100.5±8.3 cm, blood pressure [systolic 126.1±8.9 mmHg, diastolic 86.2±3.6 mmHg] were observed in T2DM cases compared to non-diabetic subjects. Fasting blood sugar 144.1±30.8 mg/dl, Post-prandial blood sugar215.2±50.6 mg/dl, blood urea 29.1±5.4, creatinine 1.1±0.2 mg/dl, total cholesterol 199±40.8 mg/dl, Triglycerides 178.5±33.5 mg/dl, Low density lipoprotein cholesterol129.5±26.8 mg/dl, very low density lipoprotein cholesterol 35.9±4.6mg/dl were significantly increased in T2DM cases than non-diabetic subjects.  LAP index 75.8±40.9 and TyG index 4.2±1.1 were also significantly increased in T2DM cases compared with non-diabetic. In the present study, significant positive correlation was observed between LAPI with BMI (r=0.166), and fasting blood sugar (r=0.189). Similarly, TyG index also showed positive correlation with BMI (r=0.275) and fasting blood sugar (r=0.191). Conclusion: The study results may concludes that significant increase in LAP index and TyG index and their significant positive correlation with BMI, blood pressure and fasting blood sugar.

Background: Because the prognosis for a number of tumours depends on the adequacy of tumour removal, the use of the endoscope in this fashion to obtain the best removal possible and to document that removal is highly recommended. This study was conducted to evaluate the advantages of endoscopy assisted cranial microneurosurgery in neoplastic lesions. Materials and methods: This prospective observational study was carried out in the Department of Neurosurgery. Study included all the admitted patients with intracranial space occupying lesions and intracranial aneurysms who underwent which micro neurosurgical techniques during study period. Study parameters included demographic, clinical, radiological an pathological profile of patients, complex anatomy incidence and identification, visualization of inaccessible parts of tumours and confirmation of contralateral extent of tumour resection. Results: Majority of patients were below 40 years of age, with median age of 38.5 years. Amongst the study group 55% were females. Neoplastic lesion was observed in 29 of 40 patients. Cerebello-pontine angle was the most common radiological location of tumor, and Meningioma was the commonest pathological diagnosis. Most common anatomical position of ventricular tumor was 3rd and 4th ventricle. Early post-operative MRI enhancement was observed in 13 patients, while residual tumor on late post-operative MRI was observed in 10 patients. Conclusion: The microscopic approach makes dissected structures visible in a straight line with the great advantages of high resolution, excellent color fidelity, and stereoscopic vision. Thus, endoscope is a useful adjunct to the microscope in anterior skull base surgeries, and posterior fossa approaches, in patients with neoplastic lesions.

Background: Endometrial carcinoma is the most common gynecologic malignancy in developed countries, with its incidence increasing due to rising life expectancy and obesity rates. Understanding the histopathological features associated with prognosis can guide treatment and management strategies. Methods: This cross-sectional study analyzed the histopathological features of 120 patients diagnosed with endometrial carcinoma at a tertiary care center. Data on age, tumor grade, tumor stage, lymphovascular invasion, myometrial invasion, and tumor microenvironment characteristics were retrospectively collected and analyzed to determine their prognostic significance. Results: The mean age at diagnosis was 53.7 years. Early-stage disease (Stage I) was observed in 56.7% of the cases, with lower tumor grades (Grade 1) present in 19.2% of patients. Significant prognostic factors included the presence of lymphovascular invasion (37.5%) and substantial myometrial invasion (greater than 50% depth in 26.7% of cases). The tumor microenvironment, particularly immune cell infiltration and stromal characteristics, was also significantly correlated with patient outcomes. Survival analysis indicated a 72.5% 5-year overall survival rate and a 65% disease-free survival rate, underscoring the impact of histopathological features on clinical outcomes. Conclusions: The study highlights the importance of comprehensive histopathological evaluation in predicting the prognosis of endometrial carcinoma. Factors such as tumor stage, grade, and microenvironmental characteristics play critical roles in influencing survival and recurrence. These findings suggest that targeted therapeutic strategies based on histopathological characteristics could potentially improve patient outcomes in endometrial carcinoma.

Background: Breast cancer remains a significant global health challenge, with its varying stages and treatment modalities influencing patients' quality of life (QoL). This study evaluates how different stages of breast cancer and their respective treatments affect QoL, focusing on physical, psychological, and social domains. Aim:  To compare QoL in breast cancer patients with operable and inoperable disease and between those undergoing breast-conserving surgery (BCS) and modified radical mastectomy (MRM). Material & Methods: This study was done in a tertiary referral university hospital and included patients based on cancer stage (I -IV) and treatment type.   A questionnaire regarding assessment of treatment modalities and quality of life (QoL) was given to patients Results were rated and assessed on the basis of filled questionnaire. Results:  The mean age was 47.5 years, with 88.9% of patients aged 30-60 years. Stage III was the most common (38.6%), followed by Stage II (23.4%). MRM was the predominant treatment (60.7%), with 57.7% receiving neoadjuvant and 79.8% adjuvant therapy. BCS patients reported the highest regain of physical strength (62.5%) compared to MRM (40.4%) and inoperable groups (37.5%) (p=0.002). Pain was significantly higher in the inoperable group (84.4%) versus MRM (30.3%) and BCS (25%) (p<0.0001). Social support was highest in the inoperable group (65.6%), though not statistically significant. Sexual interest was lowest in the inoperable group (31.2%), and emotional distress, including feelings of incompleteness, was highest in MRM patients (27.3%). Overall QoL scores were moderate to high (50.9% in the 201-300 range), with BCS patients reporting better psychological well-being and quality of time spent (62.5%) compared to MRM (47.5%) and inoperable groups (31.3%). Conclusion: Treatment modality and disease stage significantly influence QoL in breast cancer patients. BCS is associated with better physical and psychological outcomes compared to MRM and inoperable cases, though challenges in body image and sexual health persist across groups. The study highlights the need for tailored psychosocial interventions and multidisciplinary care to optimize QoL. Limitations include a small sample size (n=163), single-center design, and lack of long-term follow-up, suggesting the need for larger, multicenter studies.

Background: Early osteoarthritis (OA) of the knee is a progressive degenerative condition that significantly impacts mobility and quality of life. Arthroscopic debridement (AD) and arthroscopic-assisted unicompartmental knee arthroplasty (AA-UKA) are two minimally invasive treatment options for managing early-stage OA. While AD focuses on removing damaged cartilage and debris to alleviate symptoms, AA-UKA provides a more definitive intervention by replacing the affected compartment. This study aims to compare the functional and clinical outcomes of these two procedures. Materials and Methods: A total of 100 patients diagnosed with early knee OA (Kellgren-Lawrence grade II-III) were included in a randomized controlled study. Patients were divided into two groups: Group A (n=50) underwent arthroscopic debridement, while Group B (n=50) received arthroscopic-assisted unicompartmental knee arthroplasty. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analog Scale (VAS) for pain, and range of motion (ROM) at baseline, 6 months, and 12 months postoperatively. Statistical analysis was performed using an independent t-test and chi-square test, with significance set at p<0.05. Results: At 12 months, patients in the AA-UKA group demonstrated significantly greater improvement in KOOS scores (85 ± 5) compared to the AD group (65 ± 7) (p<0.001). VAS pain scores decreased from 7.5 ± 1.2 to 2.1 ± 0.9 in the AA-UKA group, while in the AD group, it reduced from 7.3 ± 1.1 to 4.8 ± 1.3 (p<0.05). The ROM improved by 25° ± 5° in the AA-UKA group compared to 12° ± 4° in the AD group. Patient satisfaction was also higher in the AA-UKA group (92%) than in the AD group (68%). Conclusion: Arthroscopic-assisted unicompartmental knee arthroplasty provides superior functional outcomes, pain relief, and patient satisfaction compared to arthroscopic debridement in early-stage knee osteoarthritis. While AD may offer short-term symptom relief, AA-UKA appears to be a more effective long-term solution for patients with isolated unicompartmental OA. Further longitudinal studies are recommended to assess long-term durability and complications.

Background: Oral cancer is a significant global health concern, with early detection being critical for improving patient outcomes. Conventional scalpel biopsy, although considered the gold standard, is invasive and often leads to patient reluctance. Non-invasive biopsy techniques, including oral cytology, liquid-based cytology (LBC), and brush biopsy, have emerged as alternative diagnostic tools with promising potential for early cancer detection. This study evaluates the diagnostic accuracy, sensitivity, specificity, and patient compliance of these non-invasive techniques compared to conventional histopathological biopsy. Methods: A prospective clinical study was conducted on 200 patients presenting with clinically suspicious oral lesions. Patients underwent non-invasive biopsy procedures, including oral cytology, LBC, and brush biopsy, followed by conventional scalpel biopsy for histopathological confirmation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each technique. Statistical significance was determined using p-values, and agreement with histopathology was assessed using Cohen’s kappa statistic. Results: Brush biopsy exhibited the highest diagnostic accuracy (91%), sensitivity (89%), and specificity (92%), followed by LBC (88% accuracy, 86% sensitivity, and 90% specificity). Oral cytology demonstrated comparatively lower accuracy (86%), sensitivity (84%), and specificity (88%). The patient compliance rate for non-invasive techniques was significantly higher (93-95%) compared to scalpel biopsy (72%). The pain score for scalpel biopsy was 6.8/10, whereas non-invasive techniques had lower discomfort scores (2.1-3.0/10) (p < 0.05). Conclusion: Non-invasive biopsy methods, particularly brush biopsy, demonstrate high diagnostic accuracy and patient acceptance, making them valuable alternatives for early oral cancer detection. While these techniques cannot entirely replace scalpel biopsy, they provide a highly effective screening tool, especially in high-risk populations. Future studies should explore the integration of molecular markers and AI-assisted analysis to further enhance diagnostic precision.

Background: Pediatric skin conditions, both congenital and acquired, require precise diagnostic techniques for effective management. This study evaluates the role of advanced radiological and dermatological techniques in diagnosing congenital and acquired pediatric skin conditions. Methods: A cross-sectional study was conducted on 100 pediatric participants aged 1 month to 18 years (mean age: 7.5 years). Dermatological and radiological findings were recorded, and treatment responses were assessed. Statistical analysis was performed to determine differences in treatment outcomes between congenital and acquired conditions. Results: Among the participants, 45% were male and 55% were female. Congenital skin conditions accounted for 60% of cases, while acquired conditions constituted 40%. The most common congenital conditions were congenital melanocytic nevi (35%), hemangiomas (28%), epidermal nevi (17%), and congenital ichthyosis (15%). In the acquired group, atopic dermatitis (30%) was most prevalent, followed by psoriasis (20%), viral exanthems (18%), and impetigo (15%). Ultrasound was the most frequently used imaging modality (70%), followed by MRI (15%) and X-ray (5%). Treatment response varied, with congenital conditions requiring long-term follow-up (65%), while acquired conditions showed better pharmacological response (40% significant improvement). Statistical analysis demonstrated a significant difference in treatment outcomes between congenital and acquired conditions (p = 0.04). Conclusion: Advanced radiological and dermatological techniques play a crucial role in diagnosing pediatric skin conditions. While congenital conditions often necessitate extended monitoring, acquired conditions respond more effectively to medical interventions. These findings highlight the importance of tailored diagnostic and therapeutic strategies for pediatric dermatological disorders.

Background: Feedback plays a crucial role in medical education by reinforcing learning, identifying knowledge gaps, and enhancing students’ academic performance. Effective feedback is well-established as a key component of formative assessment, fostering self-regulated learning and improving clinical competency. To address the need for structured feedback, a feedback module was implemented at Maharajah’s Institute of Medical Sciences, Vizianagaram, aimed at enhancing pharmacology learning and examination skills. Objectives: To assess students’ perceptions of the structured feedback system. To gather student suggestions for improving the feedback system. To evaluate the impact of feedback on university examination performance. Methods: A cross-sectional, questionnaire-based study was conducted among 295 second-year MBBS students who had completed their pharmacology course and attended at least four feedback sessions. A 5-point Likert scale was used for quantitative responses, while qualitative feedback was analyzed using thematic analysis. Results: 85% of students agreed that feedback helped them identify their strengths and weaknesses. 85% reported that feedback improved their answer-writing skills. 84% felt motivated to put in more effort due to feedback. 53% believed that recognizing high-performing students encouraged better performance. 35% found that feedback simplified pharmacology learning. 86% supported the continuation of the structured feedback system. A comparison with university examination results indicated a positive correlation between structured feedback and improved student performance. Conclusion: The structured feedback system significantly enhanced students' academic performance and motivation. The findings suggest that structured feedback mechanisms should be continued and further refined to improve personalization and delivery.

Introduction: The oral cavity serves as a gateway to the digestive system, with its mucous membrane reflecting the general health of an individual. AIM: Clinical study of oral mucosal lesions in patients attending dermatology outpatient department in a tertiary care centre. Methodology: This prospective observational study was conducted among patients attending the Derma OPD at Government medical College, sri ganganagar, between July 2023 and November 2023. Result: Oral candidiasis is the most common lesion observed in the study, with significant associations to diabetes and HIV, alongside varied presentations of mucosal and dermatological conditions. Conclusion: Oral mucosal lesions, often overlooked in routine evaluations, are critical diagnostic markers for systemic and dermatological diseases, emphasizing the need for thorough oral examinations in clinical practice.

Background: Pelvic fractures are common skeletal injuries leading to orthopedic hospital admissions. The risk factors associated with fractures of the pelvis have been identified as the age of the patient, females, mode of injury, and accidental crash (lateral impacts by a heavy vehicle). Younger age groups are commonly affected due to motor vehicle accidents—the current aimed to evaluate the outcome of treatment of unstable pelvic fractures with an external fixator. Methods: This study included all patients with unstable pelvic fractures who underwent surgical intervention and treated with an external fixator were included in this study. All those who were suspected of having a pelvic fracture had a pelvic binder applied at the emergency or were taken to the operating room where external fixators or pelvic clamps were applied. After adequate stabilization, definitive pelvic fixation was planned for the patients. The decision for conservative management and definitive management modality was guided by patients' age, co-morbidities, clinical condition, injury pattern, and financial constraints. Results: A total of 20 patients (18–60 years) were included. The most common age group was 31–40 years (40%), followed by 20–30 years (30%). Males constituted 65% of cases. Patients were divided into three treatment groups (A, B, and C), receiving conservative and surgical interventions. Combined osteosynthesis was frequently used. Lower extremity fractures were the most common associated injuries (30%), followed by upper extremity, head injuries, and acetabular fractures (20% each). Functional outcomes (Majeed’s score) showed Fair (30%) as the most frequent outcome, followed by Excellent and Good (25% each), and Poor (20%). Type A had the best prognosis. Conclusion: This study showed that unstable pelvic fractures predominantly affect males and most commonly in the 3^rd decade. Treatment of the cases based on the type of fractures and osteosynthesis was a common approach in the cases. Associated injuries were common in the lower extremity with 30% of cases. Majeed’s scores were used to determine the functional outcomes in this study which showed that fair results were obtained in 30% of cases which was the most common outcome, followed by excellent and good outcomes in 25% of cases.

Background: Acne vulgaris is a most common dermatological condition that affects adolescents and can have a significant impact on their mental health. Acne vulgaris can negatively affect individuals, especially in terms of psychological well-being, self-esteem, and quality of life (QoL). Aim: In this study, we aimed to evaluate the self-esteem and anxiety symptoms in adolescent patients with acne vulgaris. Methods: In this cross-sectional study fifty patients aged 18-45 years diagnosed with acne vulgaris were enrolled. Socio-demographic data were collected and analysed. Acne severity and anxiety score were assess by Rosenberg Self-Esteem Scale and Hamilton Anxiety Rating Scale (HAM-A). Results: The mean age of patient was 24.6 ± 4.2 year, with balanced gender distribution (52% male, 48% female). 40% of participants had mild acne, 45% had moderate acne, and 15% had severe acne vulgaris. The lowest mean self-esteem score was observed in participants with severe acne, measuring 12.7± 3.2, while highest mean anxiety score was observed in participants with severe acne, measuring 25.4± 5.8. Conclusion: The study shows that acne vulgaris has a significant impact on the anxiety, and self-esteem levels of adolescent patients. Dermatologists should pay attention to the psychological well-being of patients and provide psychiatric evaluation if necessary

Background: One of the greatest challenge for staff nurses working in NICU to deliver emergency nursing care to neonate with apnoea and effective nursing care helps to neonate to stabilize normal respiration and prevention of fatal consequences. Methodology: The research design adopted for this study was one group pre-test and post-test design. Results: 30 Staff nurses working in NICU Selected by Non -Probability purposive sampling .The tools used for data collection was structured questionnaire on knowledge of samples and observation checklist on practices, as an intervention administration of planned teaching regarding emergency nursing care of neonate with apnea.

Background: Background: The COVID-19 pandemic has significantly impacted individuals with chronic respiratory conditions, particularly chronic obstructive pulmonary disease (COPD). Studies suggest that COVID-19 exacerbates COPD, leading to severe complications such as increased thrombotic risk and worsened pulmonary damage. Aim: This study aims to investigate these complications by comparing COPD patients with and without a history of COVID-19. Materials and methods: This prospective study included two groups: 50 COPD patients without a history of COVID-19 as Group A and 50 COPD patients with a history of COVID-19 as Group B. In this study, we assessed various parameters including age distribution, biochemical markers (notably D-dimer levels), pulmonary function tests (FVC, FEV1, FEV1/FVC, TLC, RV), chest X-ray findings, ECG results, GOLD criteria staging, and the severity of pulmonary arterial hypertension (PAH).  Results: No significant differences were observed between the groups regarding age and sex. However, Group B had significantly higher D-dimer levels (mean 1.21±0.14 vs. 0.81±0.02) and more severe PAH (mean 28.62±4.1 vs. 20.82±3.4) compared to Group A. Additionally, Group B showed a higher prevalence of abnormal chest X-ray findings, including infiltrates and consolidation and was more frequently classified into severe GOLD criteria stages (p = 0.01). Conclusion: COPD patients with a history of COVID-19 experience significantly more severe pulmonary arterial hypertension, elevated thrombotic risk, and increased pulmonary damage compared to those without COVID-19. These results underscore the need for targeted management strategies to address the compounded effects of COVID-19 on COPD. Further research is essential to confirm these findings and develop effective interventions.

Background: Gallbladder malignancy is an aggressive disease often diagnosed at an advanced stage. Multidetector computed tomography (MDCT) plays a crucial role in staging, determining tumor extent, and assessing resectability. This study evaluates the role of MDCT in staging gallbladder malignancy and its correlation with histopathological findings. Materials and Methods: A cross-sectional analytical study was conducted at Gujarat Cancer Research Institute from March 2022 to June 2024, including 50 biopsy-proven gallbladder malignancy cases. Patients underwent triple-phase MDCT of the thorax, abdomen, and pelvis using standardized imaging protocols. Tumor morphology, local invasion, lymph node involvement, and distant metastases were assessed. Findings were correlated with histopathological results and clinical outcomes. Results: Most patients (66%) presented with advanced-stage disease (Stage IV), with liver being the most common site of metastasis (38%). Locoregional spread, vascular involvement, and nodal metastases contributed to unresectability in 76% of cases. MDCT demonstrated high accuracy in staging, with 71.42% concordance for T staging and 100% for N staging compared to pathological findings. Conclusion: MDCT is an effective imaging modality for staging gallbladder malignancy, aiding in tumor characterization, treatment planning, and surgical decision-making. It provides crucial insights into disease extent and helps predict prognosis, emphasizing its role in the management of gallbladder cancer.

Background: Paranasal sinuses (PNS) are air-filled cavities that play a crucial role in respiratory function, voice resonance, and cranial weight reduction. Pathologies affecting PNS include inflammatory conditions, anatomical variations, and neoplastic processes, which can significantly impact a patient’s quality of life. Multidetector computed tomography (MDCT) has emerged as the imaging modality of choice due to its superior resolution, multiplanar reconstruction capability, and ability to delineate soft tissue and bony structures accurately. Materials and Methods: This prospective study was conducted on 104 patients from August 2022 to July 2024 at the Department of Radiodiagnosis, Civil Hospital, Ahmedabad. Patients presenting with nasal obstruction, facial swelling, headache, or sinus-related symptoms were evaluated using a 128-slice MDCT scanner. Scans were analyzed for anatomical variations, inflammatory and neoplastic pathologies, and bone involvement. Contrast-enhanced studies were performed when malignancy or invasive fungal sinusitis was suspected. Findings were correlated with clinical presentation and, where available, histopathological diagnoses. Results: MDCT effectively identified a wide range of PNS pathologies. Inflammatory conditions were the most common, with chronic sinusitis and sinonasal polyposis observed in a significant proportion of cases. Anatomical variations, such as concha bullosa and deviated nasal septum, were frequently noted. Neoplastic lesions, though less prevalent, were accurately detected and differentiated from benign conditions. Correlation with histopathology showed high sensitivity and specificity of MDCT in diagnosing PNS diseases. Conclusion: MDCT is a vital diagnostic tool for evaluating PNS pathologies, providing precise anatomical details crucial for preoperative planning and disease management. Its ability to identify anatomical variants, assess inflammatory changes, and detect neoplastic lesions highlights its indispensable role in otolaryngologic imaging.

Background: Dermatological symptoms in children can frequently be early warning signs of systemic diseases or underlying infections. Understanding their radiological associations and clinical presentations can facilitate timely diagnosis and treatment. Methods: A retrospective study was conducted on 240 children (ages 0–15 years) with dermatological symptoms at a Telangana tertiary care hospital. Analysis was done on radiological results, systemic associations, cutaneous symptoms, demographic information, and treatment strategies. Results: There were 240 pediatric patients in the study, 127 of whom were male (53%) and 113 of whom were female (47%). Ages 6–10 years old were most affected (36%), followed by 0–5 years old (26%), and 11–15 years old (22%). In 66% of cases, passive exposure to smoking was documented. The most prevalent dermatological condition was viral exanthems (39%), followed by bacterial impetigo/pustular lesions (28%) and fungal infections (22%). The most common cutaneous manifestations were maculopapular rashes (36%), vesiculobullous eruptions (20%), and petechiae/purpura (15%). 43% of patients had radiological findings, with the most prevalent being chest X-ray abnormalities (23%), skeletal abnormalities (12%), and cranial MRI changes (8%). Supportive treatment was used 46% of the time, followed by topical antibiotics (22%), systemic antibiotics (19%), antifungal medication (13%), and adjuvant medicines including corticosteroids and antihistamines (9%). Conclusion: This study demonstrates the important clinical and radiological correlations in paediatric dermatological conditions. The findings demonstrate the importance of interdisciplinary care and comprehensive assessments for better patient outcomes.

Background :Caesarean section (CS) is one of the most commonly performed surgical procedures in obstetrics, often employed to ensure the safety of both the mother and the fetus in high-risk pregnanciesTo compare the perioperative and postoperative outcomes, including blood loss, hemoglobin levels, and complications, between spontaneous placental delivery and manual removal during Cesarean section (LSCS). Methods: A hospital-based observational study was conducted with 200 pregnant women (100 in each group) who underwent Cesarean section between November 2020 and November 2022. Group S consisted of patients with spontaneous placental delivery, and Group M comprised patients with manual removal of the placenta. Data on age, parity, gestational age, indications for LSCS, blood loss, hemoglobin levels, feto-placental delivery interval, and postoperative complications were recorded and analyzed using appropriate statistical methods. Results: The mean age, parity, and gestational age were similar between the groups. However, significant differences were observed in blood loss (mean 63.73 ± 11.56 mL for Group S vs. 114.47 ± 20.99 mL for Group M, P < 0.0001), hemoglobin levels (mean postoperative hemoglobin 10.18 ± 0.83 g/dL for Group S vs. 9.58 ± 0.82 g/dL for Group M, P < 0.0001), and hemoglobin drop (mean 0.82 ± 0.31 g/dL for Group S vs. 1.36 ± 0.35 g/dL for Group M, P < 0.0001). The feto-placental delivery interval was significantly shorter in Group M (43.95 ± 7.43 sec vs. 62.06 ± 11.43 sec, P < 0.0001). Postoperative complications, including fever, were more common in Group M (P = 0.037). Conclusion: Spontaneous placental delivery results in less blood loss, a shorter delivery interval, and fewer postoperative complications compared to manual placental removal.

Background: Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection. The mean platelet volume (MPV), a marker of platelet size, the plateletcrit (PCT), a measure of total platelet mass, and the platelet distribution width (PDW), which increases during accelerated platelet turnover, are all platelet indices. These are accessible, affordable criteria that can be found on a comprehensive hemogram, thus we conducted a study to evaluate the role of platelet count and Platelet indices as predictors of outcome in patients with sepsis at a tertiary care hospital. Materials And Methods: This cross sectional-observational study was conducted at a tertiary care centre in northern India. Patients (n=140 cases) and controls (n=70 controls) were analysed between October 2020 and October 2022. Complete hemogram parameters were obtained within 48 hours of admission. Hemogram parameters consisted of TLC, Hb, and platelet indices (include ng platelet count, MPV, PD and W, PCT). Also assessed for serum creatinine, bilirubin. Clinical parameters included body temperature, pulse rate, respiratory rate, GCS, mean arterial pressure. Results: Patient with sepsis had tachycardia, increased total leucocyte counts, decreased platelet counts (138892.09115024.049 in cases versus 220,044.78 2,28,478.262 in controls with p value) and increased PDW (17.24±1.3 VS 16.573± 0.673 with p-value of 0.0001).SIRS was present in 92% in cases vs 42% in controls (p value0.001) but amongst the sepsis patients SIRS presence was not associated with increased mortality (91.5 % in non-survivor vs 92 % in survivor). Conclusion: We found PLT and PCT can be helpful in identifying patients with sepsis from other patients in ICU setup on the basis of baseline parameters. But at baseline that is within 48 hours of admission or at the time of sepsis diagnosis none of these platelet indices differ significantly amongst survivors and non-survivors, which shows that we can’t relate these parameters to outcome in early course of illness.

Background: Gastroesophageal reflux disease (GERD) is a chronic digestive condition where stomach acid or bile irritates the lining of the esophagus. Aim: Study of association of GERD with thyroid profile. Methodology: This observational, hospital-based case-control study was conducted from January 2024 to November 2024 in the District Hospital Gyalshing, West Sikkim. Result: Our study found a significant association between GERD and thyroid dysfunction, with GERD being most prevalent in the 31-40 age group and more common in females. Conclusion: Thyroid dysfunction, particularly hypothyroidism, is associated with GERD, emphasizing the need for thyroid assessment in GERD patients, especially females.

Background: Cytological analysis of body fluids is an essential diagnostic tool in modern pathology, playing a crucial role in detecting malignant, inflammatory, and infectious diseases. The cell population found in the sediment of the fluid gives a more accurate sample of a significantly greater surface area compared to what is acquired through needle biopsy [1, 2] objective: To evaluate type of pathology on cytopathology: neoplastic, inflammatory or other and to classify as per age, sex, demography and as per microscopic morphology of malignant fluids. Method: The present study was conducted on body fluids received in the Cytopathology section of Department of Pathology, PDU Medical College and Hospital; Rajkot, Gujarat, India  for duration of 18 months from September 2022 to February 2024. A total of 783 cases were studied. Data was collected using pre-structured proforma. Clinical details, volume, colour and clarity were documented from the requisition. Smears were prepared, stained and examined. Results:  219 patients were aged 60 years and above. 67.9% of patients were males. 85.2% of patients were from rural background and 72.7% of patients belonged to lower socioeconomic status. Pleural fluid specimen was the most common specimen and was obtained in 493 patients followed by 135 patients whose peritoneal fluid was obtained. 63% of patients were diagnosed with infective/ inflammatory etiology. 66.68% of fluids showed malignancy where most commonly identified was Adenocarcinoma. Conclusion: The cytological examination of body fluids remains a cost-effective, minimally invasive, and highly informative diagnostic procedure in a tertiary care setting. It continues to be invaluable in the rapid assessment and management of patients, guiding clinical decision-making, and contributing to better health outcomes.

Background: Rotator cuff repairs are commonly performed through either arthroscopic or mini-open surgical techniques. Despite extensive clinical application, debate continues regarding the most effective method in terms of recovery, pain management, and functional outcomes. Objective: This meta-analysis aims to compare the clinical outcomes of arthroscopic versus mini-open rotator cuff repair techniques, synthesizing data from 15 studies to determine which method offers superior results. Methods: We conducted a systematic review and meta-analysis of studies published up to 2024, including randomized controlled trials and cohort studies that compared arthroscopic and mini-open rotator cuff repairs. Key outcomes analyzed included postoperative pain, functional improvement, complication rates, and re-tear rates. Data were extracted and pooled using random-effects models to compute comparative effect sizes and 95% confidence intervals. Results: The meta-analysis included a total of 15 studies, encompassing 917 patients—461 treated arthroscopically and 456 with the mini-open approach. Arthroscopic repair was associated with significantly lower pain scores (Standardized Mean Difference: -0.82, 95% CI: -1.15 to -0.49, p < 0.001) and higher functional outcome scores (Odds Ratio: 1.85, 95% CI: 1.22 to 2.78, p = 0.004) compared to mini-open repair. The rates of complications were lower, and the re-tear rates were significantly reduced in the arthroscopic group (Risk Ratio: 0.58, 95% CI: 0.36 to 0.93, p = 0.024). Conclusion: This meta-analysis provides evidence that arthroscopic rotator cuff repair results in better pain management, improved functional outcomes, fewer complications, and lower re-tear rates compared to mini-open techniques. These findings support the preferential use of arthroscopic repair for rotator cuff injuries in clinical practice, considering the patient-specific factors that may influence surgical outcomes.

Background: Cervical cancer is the fourth leading cause of death in females worldwide. In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant stage with adequate and repetitive cytological screening by conventional Papanicolaou (Pap) smears. Aim of this study was to study the role of conventional Pap smear in detecting premalignant and malignant lesions as well as non-neoplastic lesions of cervix. Methods: It is a retrospective study of 187 pap smears studied from 1st September 2024 to 30 September 2024, received in Pathology department of a tertiary care hospital at JLN medical college Ajmer, Rajasthan. Samples are collected from women between 21 to 80 years presenting with some gynaecological ailments.Smears were reported as per the Bethesda system for cervical cytology. Results: Out of 187 women, cytological evaluation revealed inflammatory smears in 99 cases(52.66%), NILM in 44cases (23.40%), and unsatisfactory samples in 22 cases(11.70%). Bacterial vaginitis was found in 11 cases(5.85%), while normal cytology was observed in 4 cases(2.13%). Altered bacterial flora in 3 cases(1.60%)and HSIL were identified in 3 cases (1.60%), with atrophic inflammatory smears in 1 case(0.53%). Conclusions: Pap smear test is a simple, safe, noninvasive, economical OPD based procedure which enables proper management at an early stage by detecting early cervical changes.

Background and Objective: Dengue fever is a globally significant arboviral infection with increasing incidence and geographic spread. Acute kidney injury (AKI) is an underrecognized complication of dengue that can significantly impact patient outcomes. This study aimed to determine the prevalence, clinical characteristics, and outcomes of AKI in dengue patients at a tertiary care center. Material and Methods: This prospective observational study was conducted on 114 dengue-positive patients admitted to our tertiary care center. Patients were diagnosed with dengue fever based on positive NS1 antigen and/or IgM antibody tests. AKI was defined and classified according to the KDIGO 2012 criteria. Clinical parameters, laboratory findings, and outcomes were analyzed. Results: Among 114 dengue patients, 22 (19.3%) developed AKI. Of these, 11 (50%) had Stage I, 7 (31.8%) had Stage II, and 4 (18.2%) had Stage III AKI. Compared to patients without AKI, those with AKI had significantly higher rates of severe dengue (p<0.01), prolonged hospital stay (p<0.001), and mortality (p<0.05). The mean duration of hospitalization was 6.2±2.1 days for patients without AKI versus 11.4±4.3 days for those with AKI. Among AKI patients, 6 (27.3%) stayed for 5-7 days, 12 (54.5%) for 8-14 days, and 4 (18.2%) for more than 15 days. Risk factors associated with AKI included older age, pre-existing comorbidities (diabetes, hypertension), severe dengue manifestations, and use of nephrotoxic medications. Conclusion: AKI is a common complication in dengue fever with a prevalence of 19.3% in our study population. The development of AKI significantly extends hospital stay and increases mortality risk. Early recognition of risk factors, regular monitoring of renal parameters, judicious fluid management, and avoidance of nephrotoxic drugs are crucial for preventing and managing AKI in dengue patients.

Background: Fractures in the calcaneus bone are the most common among tarsal bone injuries. Historically, these fractures were treated conservatively, but there is a growing trend towards surgical intervention. However, the outcomes of operative treatment have been plagued with complications. Aim: The aim of this study was to examine the Clinico Radiological outcomes in joint depressed calcaneal fractures treated with an extensile lateral approach and fixed with plating. Material and Methodology: This study was conducted at a tertiary care hospital using a prospective design. It involved 51 patients who had sustained joint depressed intra-articular calcaneal fractures. The patients' heels were evaluated using lateral and axial X-rays. The fractures were classified based on the lateral radiographs using the Essex Lopresti classification system The preoperative period evaluation involved calculating the Bohler's and Gissane's angles. The functional score at presentation was measured using the AOFAS Ankle Hind foot scale. Post-operative evaluation was done using X-rays and AOFAS scores at each follow-up visit. The collected data was analyzed using SPSS Version 20.0 software. Results: According to the Ankle-Hind foot scale, the distribution of patients based on functional outcomes showed that 33.33% had an excellent outcome, 60.79% had a good outcome, & 5.88% had a fair outcome. The soft tissue complications were minimal. Conclusion: In cases of joint depressed calcaneal fractures, open reduction and internal fixation with a lateral extensile approach yielded better functional outcomes without significant complications.

Background: Postoperative complications significantly impact patient recovery, prolong hospital stays, and increase healthcare costs. This study aimed to evaluate the frequency and types of postoperative complications following major obstetric and gynecological surgeries, along with identifying associated risk factors. Methods: A prospective hospital-based observational study was conducted on 200 patients undergoing major obstetric and gynecological surgeries at KIMS, Amalapuram, from December 2020 to November 2022. Data on patient demographics, surgical details, and postoperative complications were collected and analyzed using descriptive statistics, Chi-square tests, and ANOVA. Results: The mean age of patients was 29.54 ± 22.60 years, and 66% had a BMI below 25 kg/m². Obstetric surgeries constituted 47%, while 53% were gynecological. Febrile morbidity (8.5%), urinary retention (6%), and surgical site infections (1.5%) were the most common complications. Patients with low hemoglobin levels (<10 g/dL) had significantly higher complication rates (p = 0.027). Longer surgical durations correlated with increased blood loss (p < 0.0001), while no significant difference in complication rates was observed between elective and emergency surgeries (p = 0.716). Conclusion: Postoperative febrile morbidity, urinary retention, and surgical site infections were the most frequently observed complications. Risk factors such as low hemoglobin levels, prolonged surgical duration, and high BMI significantly influenced complication rates. Preoperative optimization, strict perioperative monitoring, and postoperative care protocols are essential to reducing adverse surgical outcomes.

Background: Acute decompensated heart failure (ADCHF) is a leading cause of hospitalization, and early diagnosis is crucial for optimizing management. Lung ultrasound (LUS) has emerged as a promising tool for detecting pulmonary congestion, but its accuracy compared to chest X-ray (CXR) and B-type natriuretic peptide (BNP) levels remains under evaluation. This study aimed to assess the utility of LUS in detecting pulmonary congestion and monitoring response to therapy in ADCHF. Additionally, the diagnostic accuracy of LUS was compared with CXR, and the correlation between B-lines on LUS and plasma BNP levels was evaluated. Methods: A prospective observational study was conducted on 200 patients presenting with breathlessness, palpitations, fatigue, and other heart failure symptoms. The diagnostic efficacy of CXR, BNP levels, and LUS was analysed using statistical methods, including chi-square tests and correlation analysis. Paired t-tests were used to compare changes in B-lines and BNP levels before and after diuretic therapy. A p-value <0.05 was considered statistically significant. Results: Among 200 patients, 168 (84.0%) were diagnosed with acute decompensated heart failure (ADCHF). Lung ultrasound, BNP levels, and chest X-ray demonstrated a statistically significant association with ADCHF (p < 0.0001). Lung ultrasound had a sensitivity of 90.5% and specificity of 87.5%, while BNP showed a sensitivity of 91.1% and specificity of 85.0%. Chest X-ray had a sensitivity of 76.2% and specificity of 81.3%. A strong correlation was observed between BNP levels and B-lines on lung ultrasound (ρ = 0.85, p < 0.0001). Post-diuretic therapy, the mean B-line count significantly decreased from 15.2 ± 1.12 to 6.2 ± 1.07 (p < 0.0001), and BNP levels declined from 682.8 ± 229.1 pg/ml to 101.1 ± 12.3 pg/ml (p < 0.0001), indicating effective decongestion. Conclusion: LUS demonstrated superior diagnostic accuracy compared to CXR and was strongly correlated with BNP levels in ADCHF patients. The significant reduction in B-lines and BNP levels post-diuretic therapy highlights the utility of LUS in monitoring therapeutic response. These findings support the broader adoption of LUS in the clinical evaluation and management of ADCHF.

Background: Digital and online gambling has become increasingly prevalent, leading to concerns about its psychiatric and socioeconomic consequences. This study examines the psychiatric comorbidities and financial and occupational impacts of pathological gambling in individuals engaged in digital gambling. Material and Methods: A cross-sectional study was conducted among 300 diagnosed pathological gamblers. Data were collected using structured questionnaires and clinical interviews, incorporating validated tools such as the Brief Psychiatric Rating Scale (BPRS), South Oaks Gambling Screen (SOGS), Financial Impact Questionnaire, and Work Performance Scale (WPS). Statistical analyses included descriptive statistics, correlation analysis, and multiple regression modeling using SPSS version 22. Results: The study revealed significant psychiatric distress among participants, with mean BPRS scores indicating elevated levels of anxiety, depression, hostility, hallucinations, and unusual thought content. A moderate positive correlation was found between BPRS and SOGS scores (r = 0.42, p = 0.001), suggesting a link between psychiatric symptoms and gambling severity. Financial consequences were severe, with 65% reporting high debt levels and 62% experiencing a loss of savings due to gambling. A strong correlation between SOGS and financial impact (r = 0.55, p = 0.0005) highlighted the financial burden of gambling. Workplace impairments included absenteeism (55%), reduced productivity (57%), and conflicts with colleagues (50%), with a moderate negative correlation between financial impact and work performance (r = -0.38, p = 0.005). Multiple regression analysis demonstrated that the model effectively predicted financial distress due to gambling. Conclusion: Pathological gambling in the digital domain is associated with significant psychiatric, financial, and occupational impairments. The findings emphasize the need for integrated interventions addressing both mental health and financial counseling. Policymakers should implement targeted regulations to mitigate gambling-related harm. Future research should focus on longitudinal patterns and intervention effectiveness to reduce psychiatric and socioeconomic consequences.

Background: Environmental pollution is a growing public health concern, with mounting evidence linking air pollution, noise pollution, and heavy metal exposure to adverse cardiovascular outcomes. While previous studies have documented short-term effects, long-term cardiometabolic risks remain insufficiently explored, particularly in urban Indian settings. This study evaluates the association between chronic pollution exposure and cardiovascular health in Bhubaneswar, Odisha.

Objectives: This study aimed to investigate the association between chronic exposure to air pollutants, including PM2.5, NO₂, SO₂, and heavy metals, and the prevalence of cardiovascular and metabolic disorders. It sought to quantify the risk of developing hypertension, diabetes, and dyslipidemia among exposed individuals while evaluating the role of demographic and lifestyle factors in modifying these risks. Additionally, the study aimed to develop a predictive model integrating pollution exposure metrics and individual health parameters to enhance cardiovascular risk estimation. Methods: A prospective cohort study was conducted over three years, enrolling 400 adult residents of Bhubaneswar. Participants were recruited from Hi-Tech Medical College while seeking healthcare services. Air pollution exposure was assessed using real-time monitoring sensors, and biological markers of exposure were evaluated via blood sample analysis. Cardiovascular health outcomes, including hypertension, lipid profile alterations, and glucose metabolism disorders, were systematically recorded. Multivariate regression models and machine learning algorithms were employed to analyze associations and predict cardiovascular risk. Results: Air quality monitoring indicated that PM2.5 levels frequently exceeded WHO-recommended safety thresholds (85 ± 15 µg/m³), particularly during winter months. Heavy metal exposure, including lead (0.45 ± 0.08 µg/m³) and cadmium (0.10 ± 0.02 µg/m³), was also significant. Statistical analyses revealed a strong association between PM2.5 and hypertension (OR = 2.3, p < 0.01), while NO₂ exposure was linked to dyslipidemia (OR = 1.9, p = 0.03). Machine learning models demonstrated high predictive accuracy (Random Forest AUC = 0.85), underscoring the robustness of environmental determinants in cardiometabolic risk estimation. Conclusions: This study provides compelling evidence of the detrimental impact of chronic pollution exposure on cardiovascular health. The findings highlight the urgent need for policy interventions to mitigate pollution-related health risks. Future research should focus on refining predictive models and implementing targeted public health strategies to reduce environmental exposures and associated disease burdens.

Background: Alkaptonuria is a rare autosomal recessive genetic disorder found in 2-5/million live births. It results in dark brown pigmentation of connective tissues including cartilage & joint capsule that can often lead to arthropathy of large joints. However, bone fractures are unusual. In this article, we report a 65 year old male patient with pain in left hip following trivial fall along with chronic backache & knee pain. Plain radiograph showed displaced fracture neck of femur. He underwent hemi-replacement arthroplasty of left hip. Intra-operatively, soft tissues, joint capsule, femoral head appears black. Post-operatively, his urine was tested & the same turned black supporting the clinical diagnosis of alkaptonuria. At 6 months follow-up, he had a painless, mobile, stable hip.

Background: Post-COVID fatigue imposes a significant burden on individuals, affecting their physical, mental, and social well-being. It can lead to prolonged exhaustion, difficulty concentrating, and reduced ability to perform daily tasks, severely limiting quality of life. The condition may persist for months, contributing to emotional distress and social isolation. Recovery is often slow and uncertain, adding to the overall impact. Aims And Objectives: This study aims to determine fatigue status in relation to severity of initial infection and immunologic association in covid-19 recovered patients.  Methods: A prospective cohort study of 200 COVID-19 patients admitted to Gandhi Hospital. Demographic data, disease severity, and inflammatory markers (IL-2 and IL-10) were recorded at admission. Patients were followed up for 3 months post-discharge, with fatigue graded using a scale at the 1st and 3rd month. Patient data were recorded in a proforma and analyzed.The mean difference between variables was analyzed using two-way ANOVA, with a p-value < 0.05 considered statistically significant. Results: Gender distribution in the study showed 63.5% males. Age distribution showed the 41-50 age group had the most patients, with 44 males and 26 females.61% of patients reported post-COVID fatigue at 1 month, and 54.5% at 3 months.Post-COVID fatigue by gender showed 60% of fatigue cases in males at 1 month, and 58% at 3 months, with females having slightly higher fatigue.Fatigue severity was higher in males and females at 1 month,Severe fatigue persisted at 3 months in both genders.Oxygen support during admission showed a higher incidence of post-COVID fatigue in patients requiring oxygen, especially those on mechanical ventilation. Higher inflammatory markers (IL-2 and IL-10) correlated with more severe post-COVID fatigue, indicating a link between disease severity and fatigue.IL-2 and IL-10 values were analyzed, showing higher levels in post-COVID fatigue patients, with slightly higher IL-10 values in females compared to males. Two-way ANOVA showed statistically significant results, further supporting the correlation between disease severity, inflammatory markers, and post-COVID fatigue. Conclusion: Post-COVID fatigue is a major concern for recovering patients. Inflammatory markers assessed at admission can predict disease severity and the likelihood of fatigue. Our study found a positive correlation between inflammatory markers, age, and post-COVID fatigue. Early assessment and grading of fatigue aid in timely intervention and rehabilitation. Females, being more prone to fatigue, should receive targeted counseling and support.

Background: Pre-eclampsia, is one of the leading cause of maternal and perinatal morbidity and mortality world-wide. Preeclampsia accounts for majority of referrals in tertiary care center. Objective: To study the maternal and perinatal outcome in patients with severe pre eclampsia Materials and methods: This was a prospective study conducted in the Government maternity hospital, S.V medical college, Tirupati for 6 months duration. Total 74 women with severe pre eclampsia after 20 weeks of gestation were included. Women with medical complication like anemia, pre-existing hypertension, epilepsy, diabetes, vascular or renal cause, multiple gestations were excluded. Patients were managed as per existing protocol after proper history, examination and investigations. Magnesium sulphate was the drug of choice for controlling convulsions and blood pressure was controlled either by labetalol or oral nifidipine. Results: Out of 74 cases of severe pre eclampsia, majority (64%) were in the age group 20-30 years and 83% primigravida. Edema (83.8%) was the most common presenting feature followed by headache (43%) in present study. 64% of severe pre eclampsia women were delivered vaginally and about 21% delivered by caesarean section .Maternal complication like PPH in 8.1%, eclampsia in 16%, DIC 1.35%, HELLP syndrome in 1.35%, pulmonary edema in 1.35%, and maternal deaths were seen in 1.35% of patients with severe pre eclampsia. In our study low birth weight was seen in 80% cases, fetal growth restriction in 4% and intra uterine fetal demise in 9.4% in patients with severe pre eclampsia and perinatal mortality seen in 4% cases. Conclusion: Maternal and perinatal complications are more in severe pre eclampsia and eclampsia patients. Good antenatal care, early diagnosis and prompt treatment can prevent severe pre eclampsia and eclampsia.

Eosinophilic fasciitis (EF) is an uncommon connective tissue disorder marked by symmetrical, painful swelling accompanied by progressive induration and thickening of the skin and soft tissues. This case report details the clinical manifestations of a 48-year-old female patient diagnosed with EF after a deep biopsy involving fascia and muscle and magnetic resonance imaging. The patient was initiated on oral glucocorticoids at a dosage of 40 mg daily. Upon follow-up, the patient exhibited remission with substantial improvement in the clinical manifestations

Cortical blindness is a type of cerebral blindness characterized as vision loss caused by injury to the visual pathway’s posterior to the lateral geniculate nuclei, with intact pupillary reflexes and without any other ocular impairments. In this report, we describe a 42-year-old female who presented with bilateral acute painless loss of eyesight following cardiac arrest, as well as bilateral plantar extensor weakness with varied weakening of both lower limbs. Recognising it may contribute to better management and outcomes. Education of health care personnel is critical because many scenarios are initially misdiagnosed as conversion disorder or malingering, postponing diagnosis while potentially harming the patient.

Introduction: Induction of labour (IOL) is a widely used obstetric intervention aimed at artificially initiating labour, with its global prevalence nearly doubling since 1990. AIM: The aim of study is to compare effectiveness of foleys catheter v/s castor oil for cervical ripening and labor induction in multigravida patients. Methodology: This randomized controlled and observational clinical study was conducted at the Department of Obstetrics and Gynecology, Mathura Das Mathur Hospital, attached to Dr. S. N. Medical College, Jodhpur, Rajasthan, India. The study was carried out after obtaining institutional ethics committee approval and continued until the required sample size was achieved. Result: Foley’s catheter induction resulted in a significantly lower C-section rate (10% vs. 32.5%, p=0.013) and shorter induction-to-delivery interval compared to castor oil, which had higher maternal complications like diarrhea, nausea, and vomiting. Although fetal complications and NICU admissions were higher in the castor oil group, the difference was not statistically significant (p=0.238 and p=0.235, respectively). Conclusion: Foley’s catheter is a safer and more effective method for cervical ripening and labour induction than castor oil, with lower rates of oxytocin use, C-sections, and maternal and fetal complications.

Background: Risk behaviors among college students pose significant health risks. This study aimed to assess the prevalence of physical inactivity, substance use, risky driving behaviors, sexual health risks, and psychological distress among undergraduate students in Gandhinagar, Gujarat. Methods: A cross-sectional survey was conducted among 420 college students aged 17-24 using a shorter Youth Risk Behavior Scale version. Participants were selected proportionately from various undergraduate programs, and data were collected through a self-reported questionnaire. Statistical analysis determined the prevalence and associations of risk behaviors. Results: The study found a high prevalence of risk behaviors. Physical inactivity was reported by 37.5%, alcohol consumption by 22.4%, and smoking by 15.8%. Risky driving behaviors were common, with 42.6% not wearing helmets and 37.2% using mobile phones while driving. Sexual risk behaviors included unprotected intercourse (18.9%) and multiple sexual partners (12.3%). Psychological distress was significant, with 45.3% experiencing high stress, 25.8% reporting depressive symptoms, and 12.1% having suicidal thoughts. Digital addiction was notable, with 55.4% spending more than four hours daily on mobile devices. Conclusion: The findings emphasize the need for interventions to address risk behaviors among college students. Universities and policymakers should implement awareness campaigns, mental health support, and lifestyle modification programs to promote healthier behaviors. Addressing these concerns proactively can enhance long-term well-being in young adults..

Introduction: Laparoscopic adrenalectomy is the gold standard for adrenal pathologies, including bilateral adrenal tumors. This report presents a case of bilateral adrenal masses associated with medullary thyroid carcinoma (MTC), managed with simultaneous bilateral laparoscopic adrenalectomy followed by delayed total thyroidectomy. Case Report: A 35-year-old male with a history of abdominal pain, headaches, and hypertension was diagnosed with bilateral adrenal adenomas and MTC. Elevated catecholamine levels confirmed Multiple Endocrine Neoplasia Type 2A (MEN2A). The patient underwent bilateral laparoscopic adrenalectomy with minimal blood loss and no complications. A total thyroidectomy is planned after achieving normotension. Discussion: Simultaneous bilateral laparoscopic adrenalectomy is a safe, time-efficient procedure, ensuring minimal scarring and rapid recovery in patients with bilateral adrenal tumors, as demonstrated in this MEN2A case. Although less commonly performed, it provides a viable approach for bilateral adrenal pathologies, with various surgical approaches available.

Background: To impart interest among new medical students, the facilitator should use new teaching learning method with available technologies according to changing trends in the medical field. Team based learning (TBL) is one active learning process that shoots up the individuals’ strength by helping them to indulge in a teamwork to achieve a common goal. The aim of this study was to analyse weather TBL is enhancing the academic performance of the students and is better than Conventional Didactic Lecture (CDL). Method: The study was an Experimental Crossover Study conducted on 124 first phase MBBS Students. They were divided into two groups, Group A and Group B randomly. In the first month, Group A was taught by TBL and Group B was taught by CDL. In the second month, the sequence was changed. Assessments were done at end of each month and compared between the two groups. Result: At the end of first month, it was seen that Group A performed significantly better than Group B (p=0.035) and at end of second month, Group B performed significantly better than group A (p<0.001). Also it was seen that groups performed better with TBL than CDL. The students liked TBL method more than CDL because they can understand better, remember and got clarity on the topic. Conclusion: New methods of teachings like TBL should be facilitated among students to increase interest, attentiveness and retention capacity.

Background: Endothelial dysfunction plays a critical role in the pathogenesis and progression of hypertension. Biomarkers such as nitric oxide (NO), endothelin-1 (ET-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) have been implicated in vascular dysregulation. This study aimed to evaluate the association between endothelial dysfunction biomarkers and hypertension severity and to develop a predictive model for risk stratification. Methods: This cross-sectional study was conducted at SMS Medical College, Jaipur, from January 2024 to January 2025, with a total of 40 hypertensive individuals. Biomarkers (NO, ET-1, sVCAM-1) were quantified using ELISA, and blood pressure measurements classified participants into mild, moderate, and severe hypertension groups. One-way ANOVA test assessed biomarker differences across severity groups, while Pearson correlation evaluated associations with systolic blood pressure. Logistic regression determined the independent contribution of biomarkers to hypertension severity, and Random Forest and SVM models were developed for predictive classification, with ROC curves and AUC analysis assessing model performance. Results: NO levels were significantly lower in severe hypertension (p < 0.001), while ET-1 and sVCAM-1 levels were elevated with increasing severity (p = 0.002 and p = 0.004, respectively). NO showed a strong inverse correlation with systolic blood pressure (r = -0.52, p < 0.001). Regression analysis identified NO (β = -0.42, p < 0.001) and ET-1 (β = 0.39, p = 0.002) as independent predictors of hypertension severity. Predictive modelling achieved AUC values of 0.85 (Random Forest) and 0.83 (SVM), demonstrating high classification accuracy. Conclusion: Endothelial dysfunction markers, particularly NO and ET-1, are significantly associated with hypertension severity. These findings support biomarker-based risk assessment and predictive modelling for improved hypertension management. Future research should explore larger cohorts and longitudinal follow-ups to enhance clinical applicability.

Background: Vesicovaginal fistula (VVF) is a distressing condition resulting in continuous urinary incontinence. This study analyses the outcomes of VVF management at Gandhi Medical College from September 2021 to June 2024, focusing on surgical approaches and patient selection for optimal outcomes. Methods: A retrospective review of 25 patients treated for VVF in the Department of Urology, Gandhi Hospital, Secunderabad, was conducted. Data on patient demographics, surgical records, and postoperative complications were analysed. Results: The mean patient age was 38.6 years. All cases were due to iatrogenic injury during hysterectomy or LSCS. Fistula sizes were <0.5 cm (5 patients), 0.5-2.5 cm (11 patients), and >2.5 cm (7 patients). All fistulas were supratrigonal, not involving the ureteric orifice. Three patients had two fistulas; the rest had one. Two patients underwent early open repair within 2 weeks; 21 underwent delayed repair after 3 months. Laparoscopic repair was performed in 13 patients (52%), open repair in 7 (28%), and endoscopic fulguration in 5 (20%). Mean hospital stay was 3.5 days for laparoscopic repair, 7 days for open repair, and 2 days for endoscopic repair. Recurrence occurred in 2 patients after endoscopic fulguration, later managed by laparoscopic repair. Bowel injury and surgical site infection were reported in one patient each after laparoscopic and open repair respectively. Conclusion: Laparoscopic repair is as effective as open repair for VVF, offering shorter hospital stays and less postoperative pain when proper surgical principles are followed. Endoscopic fulguration requires careful patient selection for best results. Early and delayed interventions yielded similar outcomes. Brief summary: Laparoscopic repair emerges as a viable and effective option for VVF management, ensuring shorter hospital stays and less postoperative pain compared to traditional open repair.Endoscopic approaches, while beneficial in terms of hospital stay and pain, showed a higher recurrence rate, indicating the need for judicious patient selection and possibly reserving this method for smaller, less complex fistulas

Background: A serious public health concern, dengue is particularly prevalent in tropical and subtropical areas. Undergraduate medical students are essential to the therapy and prevention of illness. Objective: This study aimed to evaluate the knowledge, attitude, and practices (KAP) regarding dengue among undergraduate students at Chikkamagaluru Institute of Medical Sciences (CIMS). Methods: A cross-sectional study was conducted using a structured questionnaire assessing knowledge of transmission, symptoms, and prevention; attitude toward prevention and control; and actual preventive practices. Results: The results showed that although the majority of students knew enough about dengue, there were gaps in several areas, such early symptom diagnosis and vector control. Although most students had good attitudes on dengue prevention, some of them showed misunderstandings. There was variation in the methods used to avoid dengue, with some students not always adhering to precautions including using insect repellents and clearing out breeding grounds. Conclusion: Despite the largely favourable sentiments, some pupils had false beliefs. Practices differed, and certain preventative actions were inconsistent. To close these gaps and improve students' contributions to dengue preventive initiatives, educational interventions and awareness campaigns must be strengthened.

Background: Endotracheal intubation is gold standard technique in airway management but LMAs are also used safely and effectively in pediatric patients since 1990 both for controlled and spontaneous ventilation. Present study was aimed to compare ease of placement and Perioperative Complications of supraglottic airway device in I-GEL and LMA – Proseal in pediatric patients posted for infraumbilical surgeries. Material and Methods: Present study was Prospective randomized controlled single blind study. 100 pediatric patients of ASA Physical status I & II of either sex, weight between 5 to 25 kg, age of 2 to 12 yrs of group posted for infra-umbilical surgeries were allocated into two groups as per computer-generated random allocation plan, Group I- IGEL(n=50) and Group P - LMA Proseal (n=50). Results: Overall success rate for insertion of I-Gel was 94% and for LMA- Proseal 80%. (p value 0.37) I- gel could be inserted successfully in first attempt in 31 patients (62%) out of 50 patients however, LMA- Proseal could be inserted successfully I in first attempt in 24 patients (48%) out of 50(p<0.05 HS). Time required for successful insertion for I-GEL was 27.23 ± 4.00sec. And for LMA Proseal was 33.47 ± 2.69 sec (p<0.0001). In the present study, Ryle’s tube insertion was successful in 100% patients in the first attempt in both the groups. Conclusion: I-Gel is a safe and suitable supraglottic airway device as compared to LMA -Proseal in pediatric patients for controlled ventilation as judged by better success rate of insertion with less insertion attempts stable hemodynamics, good oxygenation, adequate ventilation and lesser incidence of perioperative complications.

Background: Cervical cancer is a major health issue in India, especially in rural areas where screening access is limited. This study investigates cervical cytological abnormalities among infertile women in rural Rajasthan, where the intersection of reproductive health and cervical screening is understudied. Methods: A cross-sectional study was conducted with 650 infertile women in rural Rajasthan, India, using liquid-based cytology. Demographic data, reproductive histories, and risk factors were collected via questionnaires. Statistical analysis included chi-square tests and logistic regression. Results: The prevalence of cervical cytological abnormalities was 14.6%. High-grade squamous intraepithelial lesions (HSIL) were the most common abnormality (5.2%). Significant risk factors included early sexual debut (<18 years) and multiparity (≥3 children). Low prior screening rates (12%) were noted. Conclusion: There is a high burden of cervical abnormalities among infertile women in rural Rajasthan. Integrated screening programs, HPV vaccination, and awareness campaigns are urgently needed.

Background: Delayed or non-union of fractures remains a substantial complication following surgical intervention. Teriparatide (rh-PTH), an osteoanabolic agent, has demonstrated potential in expediting fracture healing. This prospective observational study evaluated its efficacy in surgically corrected comminuted fractures. Methods: A cohort of 50 patients undergoing surgical correction for comminuted fractures was enrolled in the study. Teriparatide (20 mcg/day subcutaneous) was administered postoperatively for a duration of three months, commencing on postoperative day three or upon the detection of non-union. Clinical and radiographic assessments were conducted periodically for a period of up to twelve months. Results: Radiological union was achieved in 92% of cases, with the majority demonstrating union within a time frame of three to nine months. Functional recovery was substantial, with 52% of patients attaining full range of motion. Mild adverse effects, such as nausea (52%) and dizziness (28%), were reported. Conclusion: Teriparatide therapy exhibited favorable outcomes in terms of fracture healing and functional recovery, warranting its consideration as a complementary approach in managing comminuted fractures.

Background: A prospective, randomized, double blind study to compare the efficacy of alkalinized lignocaine, plain lignocaine or air for intubated patients and its effect on post intubation morbidities by inflating endotracheal tube cuff with lignocaine or alkalinised lignocaine in place of air. A unique, efficient and easy method designed to decrease cough and sore throat during emergence. Methods: After approval from institutional Ethical Committee, and written informed consent from 90 patients aged 18-60 years of A.S.A class I & II, posted for elective surgical procedures of duration more than two hours under general anaesthesia were included. Randomization was done into three groups of 30 patients each. Group A: ETT cuffs inflated with Air, Group B: ETT cuffs inflated with plain lignocaine (preservative free) and Group C: ETT cuffs inflated with alkalinized lignocaine. Postoperatively patients were assessed for Sore throat grade, hoarseness of voice grade and cough grade. Results: incidence of smoothness of extubation was significantly higher in Group C compared to Group A and Group B (26.7% vs. 16.7% vs. 93.3%). Sore throat grade, hoarseness of voice grade and cough grade was significantly lower in Group C at the end of 2 hours and 4 hours compared to Group A and Group B. Conclusion: ETT cuffs inflated with alkalinized lignocaine is very effective in reducing the laryngotracheal morbidity in the immediate postoperative period and It also helps in smoother extubation by decreasing haemodynamic response and bucking over the tube. Alkalinized lignocaine provides an improved protective effect in preventing postoperative laryngotracheal morbidity in form of coughing

Background: The long-term success of dental implants depends significantly on the distribution of occlusal forces and the resulting peri-implant bone stress. Different occlusal schemes can influence the biomechanical response of the implant and surrounding bone, potentially affecting implant stability and longevity. This study aimed to evaluate the effect of different occlusal schemes on peri-implant bone stress using finite element analysis (FEA). Materials and Methods: A three-dimensional finite element model of a mandibular posterior segment was developed, incorporating an endosseous implant with surrounding bone. Three occlusal schemes were analyzed: (1) canine-guided occlusion, (2) group function occlusion, and (3) balanced occlusion. A vertical occlusal load of 200 N was applied, and stress distribution in peri-implant bone was assessed using von Mises stress analysis. Results: The highest peri-implant bone stress was observed in the canine-guided occlusion model (145 MPa), followed by group function occlusion (120 MPa), and the lowest stress was recorded in the balanced occlusion model (95 MPa). Stress concentrations were predominantly found at the crestal bone level in all models. Balanced occlusion demonstrated the most even stress distribution, whereas canine-guided occlusion resulted in localized stress peaks. Conclusion: Occlusal schemes significantly impact peri-implant bone stress distribution. Balanced occlusion exhibited the most favorable stress distribution, potentially reducing the risk of peri-implant bone loss. These findings highlight the importance of selecting appropriate occlusal schemes in implant prosthetics to enhance implant longevity and peri-implant health.

Introduction: According to the WHO, preterm birth is defined as babies born alive before 37 weeks of pregnancy. Preterm births may occur due to spontaneous preterm labor or medical indications requiring early induction or cesarean delivery. AIM: The aim of study is comparison of safety and effectiveness of intravenous Mgso4 and oral nifedipine in treatment of preterm labour. Methodology: This prospective randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology at Mathuradas Mathur Hospital, affiliated with Dr. S. N. Medical College, Jodhpur, Rajasthan, India. Result: Nifedipine was more effective than MgSO₄ in prolonging labor beyond 48 hours (p=0.045) and had better neonatal outcomes, including higher APGAR scores at 5 minutes (p=0.003) and lower neonatal morbidity. However, neonatal death rates did not show a statistically significant difference between the two groups (p=0.3048). Conclusion: Nifedipine is as effective as magnesium sulfate in inhibiting preterm labor, with better neonatal outcomes, fewer side effects, and easier administration, making it a preferable option.

Introduction: Rabies is a deadly viral disease, and post-exposure prophylaxis (PEP) plays a critical role in preventing it. However, many individuals seek treatment based on incorrect beliefs and unhealthy practices after animal bites. AIM: This study aims to assess the common myths and unhealthy wound care practices among patients attending the Anti-Rabies Clinic at Sardar Patel Medical College, Bikaner. Methodology: This cross-sectional study was conducted over a period of 6 months (January 2024 to June 2024) at the Anti-Rabies Clinic SPMC Bikaner. Results- 70% patients were male, mostly belonged to 21-30 years age group, 40.38% bites were from dogs, most common myth was that dogs are the only animals that can transmit rabies, 42.30% lacked the awareness about the severity of rabies. Conclusion -The findings reveal significant gaps in knowledge and wound care, suggesting that targeted educational interventions are needed to improve outcomes.

Background: A varied of amount of literature describes various types of falx lesions. This includes the calcification or ossification of falx which is considered to be physiological. The other end of the spectrum being pathological causes; including endocrine disorders, maroteaux type brachyolmia, hypertelorism, pseudoxanthoma elasticum, Chavany-Brunhes syndrome and Gorlin-Goltz syndrome. The study was conducted with the objective of analyzing the lesions of the falx from CT Brain studies conducted in our department. Material and Methods: Present study was prospective cross sectional observational study, conducted in patients undergoing CT scan of brain. CT scan was studied for the falx lesions and if present, details were noted and clinical correlation was done. Results: Among 500 patients maximum number of patients were from 51-70 years of age group followed by 31-50 years and then 11-30 years. 59 % of male patients and 41 % of female patients were encountered in our study population. Most common falx lesion noticed was falx calcification (62 cases) followed by fatty change with calcification (13 cases) and then followed by fatty change in the falx (8 cases). Falx lesions were most commonly seen in supracallosal part (51%) followed by precallosal part (26.5 %) of falx cerebri. Headache was associated with 54 % of patients with falx lesions as compared to 40 % of patients with no headache. The most common lesion was calcification (14.2%) followed by fatty changes in the falx (2.6%). Falcine meningioma were least common (0.6%). There was no correlation of occurrence of falx calcification on CT scan study with the headache of the patient in our study population. There was no correlation of occurrence of fatty falx on CT scan study with the headache of the patient Conclusion: Falx calcifications and fatty falx are considered common physiological changes in the falx.

Background: Vancomycin-resistant Enterococci (VRE) have emerged as a critical nosocomial pathogen globally, posing significant clinical challenges due to their multidrug-resistant nature. This study is important because it clarifies the possible source of resistance genes and how they spread to different bacterial strains, which could impact and perhaps transform medical approaches. This discovery has significant ramifications for healthcare practices that call for modification and adaptability4.The medical community is now quite concerned about vancomycin-resistant enterococcal infections. This study aimed to assess the prevalence of vancomycin resistance among Enterococcal species isolated from clinical specimens. Methods: A total of 150 Enterococcus isolates collected from clinical specimens (e.g., urine, blood, pus) were screened for vancomycin resistance using standard microbiological protocols. Antibiotic susceptibility testing was performed for all isolates, followed by phenotypic confirmatory tests to identify resistance mechanisms. Vancomycin MICs were determined via the broth microdilution method, with resistance defined as MIC ≥32 μg/mL. Results: Of the 150 Enterococcus isolates, 11 (7.3%) exhibited vancomycin resistance. Resistance rates were higher in males (63.6%, 7/11) than females (34.4%, 4/11). The majority of VRE isolates were recovered from pus (27.2%, 3/11) and urine (27.2%, 3/11), followed by other clinical sources. Species distribution revealed E. faecalis (7/11) as the predominant VRE, followed by E. faecium (4/11). Conclusion: Enterococci, particularly E. faecalis and E. faecium, remain key pathogens responsible for severe nosocomial infections. The emergence of vancomycin resistance in these species necessitates stringent antimicrobial stewardship and robust infection prevention strategies to mitigate their spread in healthcare environments.

Introduction: Fracture of the neck of femur continues to be one of the major orthopaedic injuries. It occurs in elderly patients with osteoporosis or in young patients suffering high energy trauma. Aims and Objectives: To evaluate long term clinico-radiological outcome of osteosynthesis in patients with femoral neck fracture. Material and Methods: Fifty patients of femoral neck fracture who underwent osteosynthesis with lag screw fixation or with valgus intertrochanteric osteotomy were studied. The patients were divided into 2 groups; Group-I (n=16) comprised of patients in whom osteosynthesis with lag screws was done and Group-II (n=34) patients had undergone valgus intertrochanteric osteotomy. Results: In Group-I at an average follow up of 41.8 weeks no patient had non-union or AVN, all heads were viable, 6.25% had OA hip & intraarticular implant penetration, 93.7% had Harris hip score from good to excellent, d’Aubigne & Postel score from good to very good & SF-36 score below 10 whereas at an average follow up of 142.37 weeks 6.25% had non-union, 75% heads were viable, 25% had AVN & OA hip, 6.25% had intraarticular implant penetration, 75% had Harris hip score from good to excellent, d’Aubigne & Postel score from good to very good & SF-36 score below 10. In Group-II at an average follow up of 55.44 weeks 2.94% had non-union, 94.12% heads were viable, 5.88% had AVN, 8.82% had OA hip, no intraarticular implant penetration, 88.23% had Harris hip score from good to excellent, 91.17% had d’Aubigne & Postel score from good to very good & 79.41% had SF-36 score below 10 whereas at an average follow up of 159.3 weeks 2.94% had non-union, 82.36% heads were viable, 17.64% had AVN, 41.17% had OA hip, 2.94% had intraarticular implant penetration, 73.53% had Harris hip score from good to excellent, 72.22% had d’Aubigne & Postel score from good to very good & 70.58% had SF-36 score below 10. Conclusion: Rate of union was found to be better in patients managed with valgus intertrochanteric osteotomy than with lag screw osteosynthesis. The incidence of avascular necrosis seems to be higher in patients of group-I as compared to group-II patients. The overall clinical & radiological outcomes in both groups became worse on long term follow up.

Background: The longevity and success of full-arch implant-supported restorations depend on the mechanical properties of prosthetic materials, particularly fracture resistance. Computer-aided design and computer-aided manufacturing (CAD/CAM) materials, including zirconia, lithium disilicate, and polymer-based composites, offer varying degrees of strength and durability. This study aims to evaluate and compare the fracture resistance of different CAD/CAM prosthetic materials used in full-arch implant-supported restorations. Materials and Methods Three groups of CAD/CAM materials were tested: monolithic zirconia (Group A), lithium disilicate (Group B), and polymer-infiltrated ceramic network (PICN) composites (Group C). Ten full-arch prosthetic frameworks were fabricated per group using a standardized CAD/CAM workflow. Each framework was cemented onto a simulated implant-supported model and subjected to compressive load testing using a universal testing machine at a crosshead speed of 1 mm/min until fracture. The mean fracture resistance values (N) were recorded and statistically analyzed using one-way ANOVA with a significance level set at p < 0.05. Results The fracture resistance values varied significantly among the tested materials. Group A (monolithic zirconia) demonstrated the highest mean fracture resistance (4500 ± 300 N), followed by Group B (lithium disilicate) with 3200 ± 250 N, and Group C (PICN composites) with the lowest resistance (2100 ± 200 N). Statistical analysis confirmed a significant difference among the groups (p < 0.001). Conclusion: Among the tested CAD/CAM materials, monolithic zirconia exhibited superior fracture resistance, making it the most suitable option for full-arch implant-supported restorations in high-load-bearing areas. Lithium disilicate offered moderate strength, whereas PICN composites displayed the lowest resistance, suggesting limited use in high-stress applications. The selection of prosthetic material should consider both mechanical properties and clinical requirements.

Introduction: The thyroid gland is usually considered resistant to infection. Primary thyroid abscess is an unusual condition in children.

Case report: A 5 years old boy presented with complaints of fever and painful neck swelling since 5 days.Ultrasonography(USG) neck revealed a 5 x 2.9 x 3.6 cm hypoechoic lesion with internal echoes in thyroid gland. Child was admitted and started on intravenous antibiotics and analgesics and underwent incision and drainage under anaesthesia.He had uneventful postoperative course and recovered well with no recurrence till 6 months of follow-up.

Conclusion: This case highlights the importance of considering thyroid abscess in the differential diagnosis of acute suppurative midline neck swellings in children. Early recognition and intervention are crucial for optimal outcomes. Possibility of immunodeficiency, preexistence thyroid anatomical abnormality must be ruled out.

Background: Haemorrhoids, a common anorectal condition, can be managed through conservative, non-surgical, or surgical approaches. For grade III and IV haemorrhoids, surgical intervention remains the gold standard. Traditional surgical methods include stapler haemorrhoidopexy and open haemorrhoidectomy. Laser haemorrhoidoplasty is a novel, minimally invasive approach using diode lasers to shrink haemorrhoidal tissue with minimal postoperative pain and faster recovery. This study aims to compare the effectiveness of laser haemorrhoidoplasty and stapler haemorrhoidopexy based on postoperative pain (VAS score), complications, and hospital stay. Materials and Methods: A prospective observational study was conducted in the Department of General Surgery at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. A total of 100 patients with grade III or IV symptomatic haemorrhoids were included and randomized into two groups: Group 1 (Laser Haemorrhoidoplasty) and Group 2 (Stapler Haemorrhoidopexy). Postoperative outcomes were assessed based on pain using the Visual Analogue Scale (VAS) at different time intervals (Day 1, Weeks 1, 2, 4, 6, and 3 months). Complications such as bleeding, urinary retention, thrombosis, anal discharge, and stenosis were also evaluated. Results: The mean operative time was significantly shorter in the laser haemorrhoidoplasty group (32.5 ± 5.1 minutes) compared to the stapler haemorrhoidopexy group (41.3 ± 4.8 minutes, p < 0.05). Postoperative pain scores (VAS) were consistently lower in the laser group at all intervals, with Day 1 scores of 4.8 ± 1.2 compared to 6.7 ± 1.5 in the stapler group (p < 0.05). Postoperative pain score(VAS) on 3 months were 0.3±0.2 compared to 1.2 ± 0.6 in stapler group (p value <0.0.5). Complication rates were also lower in the laser group, including bleeding (6% vs. 14%), urinary retention (4% vs. 10%), and anal stenosis (2% vs. 8%) with statistically significant differences (p < 0.05). Additionally, the mean hospital stay was significantly shorter for laser haemorrhoidoplasty patients (1.8 ± 0.6 days) compared to stapler haemorrhoidopexy patients (3.2 ± 0.9 days, p < 0.05). Conclusion: +Laser haemorrhoidoplasty demonstrated superior outcomes over stapler haemorrhoidopexy, with reduced postoperative pain, fewer complications, shorter operative time, and shorter hospital stays. It offers a promising alternative for the surgical management of grade III and IV haemorrhoids, providing improved patient satisfaction and faster recovery.

Background: Introduction: Breast diseases in patients during pregnancy and lactation represent a unique diagnostic challenge due to the physiological changes that occur during these periods. The hormonal milieu, characterized by elevated estrogen, progesterone, and prolactin levels, leads to increased breast density, vascularity, and ductal activity. These alterations can obscure the clinical and imaging findings, making the differentiation between benign and malignant lesions complex. Ultrasonography, as a radiation‐free, readily available modality, plays a pivotal role in evaluating breast diseases during these periods. Material and Methods: This prospective study was conducted over a 12-month period in the Department of Radiology at a tertiary care center attending pregnant and lactating patients presenting with breast complaints. Detailed clinical evaluation was followed by high-resolution ultrasound examination. Inclusion criteria encompassed patients with palpable masses, pain, nipple discharge, or other breast symptoms during pregnancy or lactation. Patients with a known history of breast malignancy or previous breast surgery were excluded. Ultrasound findings were correlated with clinical and, when indicated, histopathological diagnoses. Results: The largest proportion of patients falls within the 26–35 years age group (48%), aligning with the typical childbearing period where pregnancy and lactation are most common. Fibroadenomas are the most common breast condition in this cohort, accounting for 36% of cases. Ductal ectasia (25 cases) is common in lactating breasts due to hormonal effects, where breast ducts can enlarge or become dilated. Cystic changes (20 cases) particularly galactoceles, are a common benign finding during lactation. Abscess formation (15 cases) typically associated with mastitis, are indicative of an infectious process. Benign Lesions (concordance 98%) are high concordance rate (98%) between ultrasound diagnosis and histopathological confirmation for benign lesions demonstrates that ultrasonography is highly accurate in identifying benign breast conditions such as fibroadenomas and galactoceles. Conclusion: Ultrasonography is an invaluable tool for the evaluation of breast diseases in pregnant and lactating patients. Its ability to differentiate benign from malignant lesions aids in timely management, minimizing unnecessary interventions during these critical periods.

BACKGROUND: Perinatal asphyxia increases the risk of renal injury in newborns, particularly in preterm infants with immature kidneys. Oxygen deprivation, acidosis, and hypotension can lead to acute kidney injury (AKI) or renal dysfunction1. The prevalence of renal injury in asphyxiated newborns depends on the severity of asphyxia, gestational age, and other complications2. Early detection using biochemical markers like serum creatinine and blood urea nitrogen (BUN) is vital for timely intervention, preventing long-term renal damage, and improving neonatal outcomes. AIMS AND OBJECTIVES: 1. To predict the likelihood of renal failure in newborns with asphyxia. 2.To assess the biochemical parameters in newborns with perinatal asphyxia. 3.To evaluate the severity of asphyxia using the APGAR score. 4.To examine the relationship between serum sodium, potassium, calcium levels, and electrolytes with the severity of asphyxia. METHODS: A prospective, observational study was conducted at GSL Medical College in Rajahmundry, Andhra Pradesh, India. The sample size was calculated using the Epi Info Software, based on the population survey model. According to the inclusion and exclusion criteria, 62 neonates were deemed eligible. Simple random sampling was employed for participant selection. The study was approved by the ethics committee, ensuring confidentiality. A thorough history, including personal and family details, was taken from each parent. Demographics (e.g., gender) and clinical findings were recorded. Data was entered into a case record form and analyzed statistically. Biochemical parameters were evaluated at 24, 48, and 72 hours. The data was entered into MS Excel 2019, and analysis was performed using Microsoft Excel and Epi Info version 7.2.5 statistical software. A p-value of <0.05 was considered statistically significant. A Chi-square test was applied to correlate urine sodium and urine creatinine with the severity of asphyxia. RESULTS: In the study, 58% of neonates were boys and 41.9% were girls. APGAR scores at 5 minutes improved in some neonates, with a score of 7 being most common. Asphyxia severity, based on APGAR at 1 minute, was severe in 38%, moderate in 24%, and mild in 38%. Renal dysfunction occurred in 67.7%, while 32.2% had normal renal function. Urine analysis was normal at 24, 48, and 72 hours. Significant correlations were found between asphyxia severity and renal dysfunction. Serum sodium, potassium, urine creatinine, and blood urea showed increasing correlations with asphyxia severity from 24 to 72 hours. Serum calcium had a negative correlation, indicating hypocalcemia in severe asphyxia. Serum bicarbonate levels were negatively correlated, indicating acidosis in severe cases. Bicarbonate and potassium levels indicated renal dysfunction from 24 hours. CONCLUSION: The study found a 67.8% prevalence of renal dysfunction in neonates with perinatal asphyxia. Biochemical parameters were assessed at 24, 48, and 72 hours. Severe asphyxia was seen in 38% of neonates. Significant correlations between biochemical markers and asphyxia severity helped predict renal dysfunction, enabling timely intervention that prevented renal damage and mortality

BACKGROUND: Neonatal hearing loss affects 1 to 3 per 1,000 newborns globally, with higher rates in high-risk populations such as those with a family history of hearing loss or low birth weight. Early detection through screening is crucial to prevent developmental delays in language, speech, and cognitive abilities. Otoacoustic Emissions (OAE) testing is a non-invasive, reliable method used in neonatal hearing screening to detect early hearing impairments. Universal screening programs are now common in many countries, ensuring timely interventions through hearing aids or cochlear implants. AIMS AND OBJECTIVES: To assess hearing in neonates using oto-acoustic emissions (OAEs), this study will screen all newborns delivered at Bhaskar Medical College. The results will be compared with the maternal and neonatal histories to identify any correlations. METHODS: This one-year cross-sectional study, conducted at Bhaskar Medical College & Hospital, Moinabad, from January to December 2019, aimed to screen the hearing of all newborns delivered at the hospital and neonates attending the facility. Parents of eligible neonates were interviewed about maternal and neonatal history, and written informed consent was obtained. Neonates underwent hearing screening using Oto-Acoustic Emissions (OAE) in a soundproof room, with responses recorded as PASS or REFER. Follow-up screenings were conducted for neonates with REFER results, with a third screening leading to BERA testing if results remained REFER. Routine ENT investigations were performed as needed. RESULTS: In this study of 500 neonates at Bhaskar General Hospital, Oto-Acoustic Emission (OAE) testing was conducted, with ages ranging from 3 to 90 days. Among the participants, 279 (56%) were male and 221 (44%) were female. The gestational age ranged from 30 to 38 weeks, and birth weights varied from 1000g to 3800g. After the three-stage screening, 499 (99.8%) neonates passed, and 1 (0.2%) had hearing impairment. Of the 500 neonates, 87 (17.4%) failed the first screening, 71 (81.6%) passed the second, and 16 (18.4%) were rescreened. Ultimately, 1 neonate failed the third screening and was diagnosed with hearing impairment, yielding an incidence rate of 0.2%. CONCLUSION: This study aimed to evaluate the effectiveness of Oto-Acoustic Emissions (OAE) in neonatal hearing screening. A total of 500 neonates were screened at Bhaskar General Hospital. The results were analyzed to determine the prevalence of hearing impairment and the accuracy of the screening method. Among the neonates, 99.8% passed the screening, while only 0.2% were diagnosed with hearing impairment after follow-up screenings and ABR testing. The study also examined factors such as gender, delivery method, birth weight, and family history, which were correlated with hearing test results. The findings highlight the importance of early detection and intervention in preventing hearing-related developmental delays.

Background: Occupational hazards, particularly exposure to volatile organic compounds (VOCs) like benzene, pose serious health risks to petrol station workers. Aim: This study aimed to assess the knowledge, attitudes, and safety practices of petrol station workers regarding occupational health hazards.Design and Methods: A cross-sectional study was conducted among petrol station workers, selected through simple random sampling. Data were collected using a semi-structured questionnaire administered via face-to-face interviews. Participants included individuals engaged in fuel filling for at least six months, excluding cashiers, cleaners, and other non-fuelling staff. Demographic data, awareness of health risks, and adherence to safety measures were analysed using appropriate statistical methods. Results: Total 87 study subjects were participated in the study, the mean age of participants was 35.06. Most attendants were male (77%) and married (74.7%). Educational levels varied, with 58.6% completing secondary education. While 94.3% recognized the environmental hazards of petroleum products, only 39.1% reported undergoing regular medical examinations. Stress and headaches were prevalent, affecting 40.2% and 47.1% of attendants, respectively. Additionally, 64.4% did not change clothes immediately post-shift, underscoring gaps in personal hygiene practices. Despite awareness, none consistently used protective gloves, citing discomfort as a barrier. Conclusion: The findings highlight critical gaps in occupational safety practices and medical monitoring among petrol station attendants. Interventions, including health education, safety training, routine medical examinations, and improved hygiene protocols, are essential to mitigate health risks.

Background: Class II furcation defects present a significant challenge in periodontal therapy, often requiring regenerative approaches for optimal treatment outcomes. Chitosan, a natural biopolymer, and Platelet-Rich Fibrin (PRF), a second-generation platelet concentrate, have shown promise in promoting periodontal regeneration. This study aimed to evaluate and compare the efficacy of chitosan gel and PRF with open flap debridement (OFD) in the treatment of Class II furcation defects through clinical and radiographic assessment. Materials and Methods: This randomized clinical study included 45 patients (24 males, 21 females) with Class II furcation defects. Patients were divided into three groups: Group 1 (OFD alone), Group 2 (OFD + PRF), and Group 3 (OFD + chitosan gel). Clinical parameters such as Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Relative Vertical Clinical Attachment Level (RVCAL), and Relative Horizontal Clinical Attachment Level (RHCAL) were recorded at baseline and at 9 months postoperatively. Radiographic evaluation of Intrabony Defect (IBD) depth was conducted using intraoral periapical radiographs (IOPA) with grid analysis. Data were analyzed using SPSS 20.0 software, and statistical significance was set at p<0.05. Results: All three groups showed significant improvement in periodontal parameters over 9 months (p<0.05). PRF and chitosan groups demonstrated superior outcomes compared to OFD alone. PRF showed the highest reduction in PPD (4.42±0.73 mm) compared to chitosan (3.97±0.68 mm) and OFD (1.70±0.47 mm) (p<0.001). RVCAL gain was highest in PRF (3.26±0.69 mm), followed by chitosan (2.56±0.58 mm) and OFD (1.71±0.49 mm) (p<0.001). RHCAL improved significantly in PRF (2.80±0.56 mm) and chitosan (2.17±0.41 mm) groups compared to OFD alone (1.26±0.39 mm) (p<0.001). IBD depth reduction was significantly greater in PRF (2.06±0.41 mm) compared to chitosan (1.44±0.35 mm) and OFD alone (0.29±0.05 mm) (p<0.001). No significant difference was found between PRF and chitosan groups for most parameters. Conclusion: Both PRF and chitosan demonstrated significant potential in enhancing periodontal regeneration compared to OFD alone. PRF exhibited slightly superior results in defect fill and soft tissue healing, making it a more favorable choice for managing Class II furcation defects. However, chitosan remains a viable alternative due to its biocompatibility and regenerative properties. Further long-term studies with larger sample sizes are recommended to validate these findings.

Background: Direct ocular trauma is a major cause of unilateral visual loss in developing countries. Perhaps up to 5% of bilateral loss of vision are also due to ocular trauma. The corneal disease contributes as the second major cause of blindness worldwide. Aims- Clinical profile of corneal trauma and management in pediatric age group patients at tertiary health care center- single centre analysis. Methods and materials- In present study, 132 patients attending the Department of Ophthalmology, Pt. J. N. M. Medical College & Dr. B. R. Ambedkar Memorial Hospital, Raipur during the period of 1year and 6 months, with corneal trauma by different kinds of vegetative and organic material, from November,2011 to April,2013 in pediatrics age group patients. Results- The study showed, the maximum number of patients in the middle decades with a range of 8-12 years. Most of the patients were males (69.30%) and belonged to rural backgrounds (71.21%). The majority of patients (59.85%) were farmers or agricultural workers. The predominant traumatic agent in our study was paddy leaf injury (51.51%) and most of the patients after corneal trauma presented with corneal ulceration (75.76%). After trauma, corneal scraps done for microbiological examination showed 40.15% fungal keratitis whereas clinically 49.24% of patients appeared to be fungal keratitis. Fungal keratitis was significantly associated with paddy leaf injury. Most of the patients in our study responded to the medical management (65.15%) and the healing response was found to be good (56.58%). However, poorly responsive patients were found to have some of the predisposing factors. Structural prognosis was good (54.55%) as the patient healed with Leading to poor visual prognosis (72.73%). Conclusion- Fungal ulcers were more common than bacterial ulcers. Fungal ulcers should be suspected in every patient with a corneal lesion occurring by vegetative and organic material and should be ruled out before commencing topical medication. Early diagnosis with prompt identification of the pathogenic organism is mandatory to initiate appropriate therapy for corneal injuries to restore good vision.

Background: Acute febrile illness (AFI) is characterized by fever lasting at least two consecutive days with a temperature ≥38°C. Common causes include dengue, malaria, typhoid, urinary tract infections (UTI), chikungunya, leptospirosis, and meningitis. Changes in hematological parameters such as anemia, thrombocytopenia, leukopenia, and leukocytosis are observed in AFI patients, which may aid in early diagnosis and management. Objective: To evaluate and compare hematological parameters among various acute febrile illnesses. Methods: A cross-sectional study was conducted from December 2023 to March 2024 among 60 AFI patients admitted to the Department of General Medicine at The Oxford Medical College Hospital and Research Centre, Bangalore. Patients aged ≥18 years with fever for at least two consecutive days were included, while those with septicemia, transfusion reactions, or allergic/drug reactions were excluded. Hematological parameters, including hemoglobin, WBC count, neutrophil count, lymphocyte count, and platelet count, were analyzed. Results: Among the 60 patients, 65% were male, with a mean age of 32 years. The most common AFI was dengue (38%), followed by UTI (22%), typhoid (17%), malaria (10%), leptospirosis (7%), and meningitis (7%). Significant hematological variations were observed across different AFIs (p<0.01). Anemia (Hb <11 g/dL) was most prevalent in malaria (83%) and meningitis (75%). Leukopenia (WBC <4000 cells/mm³) was primarily seen in dengue (30%). Neutrophilia (>70%) was most common in UTI (62%) and meningitis (75%), while lymphocytosis (>40%) was frequently noted in dengue (39%). Thrombocytopenia (platelets <100,000 cells/mm³) was most prominent in dengue (87%) and malaria (66%). Conclusion: Hematological parameters can serve as valuable diagnostic indicators in AFI, aiding in early diagnosis and timely initiation of treatment before confirmatory test results are available

Background: Caudal block is commonly used in pediatric patients undergoing lower abdominal and limb surgeries as it provides safe and effective perioperative pain relief. Ketamine, a widely used adjuvant, has also been proven to provide effective and prolonged postoperative analgesia with minimal adverse effects. But the impact of caudal ketamine on the MLAC of ropivacaine remains unclear. So, this randomized study was undertaken. Given less literature on the efficacy of adjuvants in caudal block among children, the current study was undertaken. Objective: To compare duration of analgesia, hemodynamic parameters and complication in children after caudal analgesia with Ropivacaine alone and Ropivacaine with Ketamine. Methods: This is a randomized controlled study done among children below 10 years in Andhra Pradesh. The study included 100 children, divided into 2 groups. Group R included 50 children, and group RK included 50 children. Pain was assessed using FLACC score. Demography, complications, and hemodynamic parameters were compared between groups. Results: The mean age was 8 years. There is no significant difference in gender between groups. There is no significant difference in mean heart rate and mean oxygen saturation at baseline, 30 min before extubating, and 5 min, 15 min, and 30 min post extubation between groups. Time for rescue analgesia was less in the R group compared to the RK group children. There is no significant difference in the incidence of complications between groups. Conclusion: Adding caudal ketamine to ropivacaine prolongs the duration of post-operative analgesia.

Background: Maternal anemia in early pregnancy is associated with increased risks of complications for both the mother and child. Early laboratory diagnosis is essential for timely intervention and improved outcomes. This study assesses the impact of anemia on maternal and neonatal health and highlights the benefits of early screening. Materials and Methods: A prospective cohort study was conducted on 1,000 pregnant women (≥18 years) attending their first antenatal visit between 8 and 14 weeks of gestation at a tertiary maternal and child health hospital. Hemoglobin (Hb) levels were recorded, and anemia was classified as mild, moderate, or severe. The association between anemia severity and maternal complications (gestational hypertension, postpartum hemorrhage) and neonatal outcomes (preterm birth, low birth weight, small for gestational age [SGA]) was analyzed using logistic regression models.  Results: Among the 1,000 pregnancies, 18% of participants had anemia. Maternal complications were significantly associated with anemia severity, including gestational hypertension (adjusted odds ratio [aOR] for mild anemia: 1.20, moderate anemia: 1.50, severe anemia: 3.00) and postpartum hemorrhage (aOR for mild anemia: 1.35, moderate anemia: 1.60, severe anemia: 4.00). Anemia also increased the risk of neonatal complications, including preterm birth (aOR for mild anemia: 1.40, moderate anemia: 1.60, severe anemia: 3.50), low birth weight (aOR for mild anemia: 1.50, moderate anemia: 1.80, severe anemia: 5.00), and SGA (aOR for mild anemia: 1.30, moderate anemia: 1.45, severe anemia: 2.30). Conclusion:  Maternal anemia during early pregnancy is associated with significant maternal and neonatal risks, which increase with anemia severity. Early laboratory screening and timely intervention are crucial for preventing adverse outcomes and improving maternal and neonatal health.

Background: Renal stones and renal cell carcinoma (RCC) are significant health concerns with multifactorial etiologies, including genetic predisposition and dietary habits. Understanding the interplay between these factors is crucial for early identification and preventive strategies. This study aims to evaluate the association between dietary patterns and genetic susceptibility in the development of renal stones and RCC. Materials and Methods A prospective study was conducted at MMIMSR, Mullana, Ambala, over one year with a sample size of 100 participants. Patients were categorized into two groups: those diagnosed with renal stones (n=50) and those with RCC (n=50). Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and genetic predisposition was evaluated through family history and specific genetic markers related to calcium metabolism and oxidative stress. Biochemical parameters, including serum calcium, oxalate, and uric acid levels, were analyzed. Statistical analyses were performed using SPSS, with a significance level set at p<0.05. Results: Preliminary findings indicate that 60% of renal stone patients had a high dietary intake of oxalate-rich foods, while 45% of RCC patients had a diet high in processed meat and low in antioxidants. Genetic analysis revealed that 30% of renal stone patients and 40% of RCC patients had a family history of kidney disorders. Serum calcium and oxalate levels were significantly elevated in renal stone patients (p<0.01), whereas RCC patients exhibited increased oxidative stress markers (p<0.05). A positive correlation was observed between high oxalate intake and renal stone formation (r=0.65), while a diet rich in carcinogenic compounds correlated with RCC development (r=0.72). Conclusion: The study highlights a strong association between dietary habits and genetic predisposition in the development of renal stones and RCC. High oxalate intake increases the risk of renal stones, while a diet low in antioxidants and high in processed foods may contribute to RCC. These findings emphasize the need for personalized dietary recommendations and early screening for at-risk individuals.

Splenomegaly is characterized by enlargement of the spleen, distinct from hypersplenism, denoting an excessively active spleen. During pregnancy, the appearance of massive splenomegaly is a relatively rare condition, and its impact can be exacerbated by concurrent complications such as Anemia, Thrombocytopenia, Ascites, and Jaundice.We present a case of a 24-year-old primigravida at 20 weeks of gestation presented with pancytopenia with significant splenomegaly, with the spleen measuring 14 cm on examination and 20 cm on ultrasound. Lab tests showed microcytic hypochromic anemia,leukopenia and thrombocytopenia, along with deranged liver function tests . A multidisciplinary team managed her condition, providing multiple blood and platelet transfusions, as well as medications to enhance hematopoiesis. At 35 weeks and 5 days, she underwent an uneventful elective cesarean section, delivering a healthy male baby weighing 2400 grams with unresolved spleenomegaly.

Background: Spinal health is vital for mobility, productivity, and overall well-being. However, poor posture, prolonged sitting, and physically demanding jobs contribute to rising spinal disorders, particularly in Punjab’s diverse workforce. Despite the increasing prevalence of conditions like lower back pain and musculoskeletal discomfort, awareness remains limited. Understanding knowledge gaps and occupational risks is essential for developing effective preventive strategies.

Materials and Methods:This cross-sectional study assessed spinal health awareness among 400 working professionals in Punjab using a structured online questionnaire. The survey covered socio-demographics, knowledge assessment (20 multiple-choice questions), and self-reported spinal health practices. Responses were classified into Very Good, Good, Fair, and Poor knowledge levels. Data were analyzed using descriptive statistics and chi-square tests (p < 0.05).

Results: The majority of participants (64.5%) were aged 26–45 years, with 54.5% males and 45.5% females. While 38.0% demonstrated very good knowledge (>80% correct responses), 39.0% had good knowledge (60%–79%), 17.5% exhibited fair knowledge (41%–59%), and 5.5% had poor awareness (<40%). Encouragingly, 88.5% recognized the impact of prolonged sitting on spinal health, and 85.0% identified the importance of proper lifting techniques. However, 69.5% had inadequate knowledge about ergonomic workplace training, 81.0% lacked awareness of hydration’s role in spinal disc health, and 74.0% were unaware of the impact of improper footwear on spinal alignment. These findings suggest an urgent need for targeted workplace interventions and educational programs to bridge existing knowledge gaps and enhance spinal health awareness.

Conclusion: Despitemoderate-to-high awareness levels, significant knowledge gaps persist in workplace ergonomics and preventive spinal care. Employers and policymakers must integrate ergonomic training, early interventions, and awareness programs to reduce spinal disorders, enhance work efficiency, and improve workforce well-being.

Introduction: Acute abdominal pain is a common complaint in emergency departments, with acute appendicitis being one of the leading causes. Diagnosis based on clinical signs and symptoms, the diagnostic approach has evolved to include inflammatory markers such as leukocyte count, neutrophil count, and CRP. AIM: To determine the usefulness of Lymphocyte to C Reactive Protein Ratio in predicting the differentiation between Acute Appendicitis and Perforated Appendicitis. Methodology: This study is a prospective observational study. The sample size is calculated at a 95% confidence level with an α error of 0.05, based on the sensitivity of the lymphocyte-to-C-reactive protein ratio (LCR) for diagnosing acute appendicitis, which is 79.4% according to the reference seed article. Result: Our study found that acute appendicitis was more common than perforated appendicitis, with significant differences in inflammatory markers (LCR, NLR, and CRP) between the groups, while the Alvarado score showed no statistical significance. Conclusion: Inflammatory markers like LCR, NLR, and CRP are significant in diagnosing and predicting complications of acute and perforated appendicitis.

Background: Medical professionalism is one of the core accreditations by National Medical Commission for Graduate Medical Education competencies as the need to include teaching and assessment of professionalism in the formal curricula for undergraduate and postgraduate medical training has been globally acknowledged. Transmitting professionalism and professional values by role modelling is no longer recognised as sufficient. As this occurred, it became apparent that the evaluation of professionalism needed improvement and there have been calls for new methods to be developed. Assessment of professionalism not only allows for timely feedback to residents to help them improve, but also allows for development of better curriculum to prevent lapses in medical professionalism. This study is done with an aim to establish PMEX as a competent scoring system for the assessment of professionalism among medical students with the following objectives: to analyse the relevance of PMEX in current health scenario, to analyse the feasibility of PMEX in Competency Based Medical Education curriculum, to analyse the comprehensiveness of PMEX scoring system for practical application and to assess the efficacy of PMEX as a formative assessment tool for improvement of professional competency in medical students. This is cross-sectional study done at the Department of Surgery, Jorhat Medical College and Hospital clinical settings- OPD, IPD, pre-operative ward, post-operative ward, Major OT, Minor OT, Casualty and ICU/ITU. Assessors were interviewed to rate the relevance, feasibility and comprehensiveness of each item in P-MEX using a 1-10 numerical rating scale (1 strongly not relevant, 10 completely relevant) and also any comment or suggestion for improvement of PMEX was recorded. The study was conducted after for a duration of 6 months from February 2024 to July 2024 with sample size consisting of 6 faculty and 33 residents of General Surgery. Those who gave consent were included in the study. Exclusion criteria included post graduate residents on District Residency Program and faculty and residents who did not give consent. Sampling method was purposive sampling with pre- validated questionnaire and interview. Preparation of survey questionnaire consisted of four domains: doctor-patient relationship skills, reflective skills, time management and inter- professional relationship skills. Each behaviour was assessed in 5grades:1=unacceptable 2=below expectations 3=meet expectations 4=above expectations and 5=not applicable in this case. Each Resident was assessed by 6 assessors in 8 different obtaining clearance from Institutional Ethics Committee, Jorhat Medical College and Hospital. Feasibility has a mean of 7.34 with a range of 4-9, relevance with a mean of 7.34 and range 4-9. This shows that feasibility and relevance and comprehensiveness of this tool is very relevant in assessment of professionalism. Comprehensiveness has a mean of 7.71 with a range of 5-9. This shows that it is extremely relevant. The average improvement of the results of post-graduates starting from assessment 1 to assessment 8 shows that this tool is efficacious in formative assessment of professionalism among students. Based on the results, it is concluded that P-MEX is a competent scoring system for the assessment of professionalism among medical students.

Background: Measles, a highly contagious viral disease, primarily affects children. Despite global vaccination efforts, outbreaks continue to occur in under-vaccinated populations. This study examines the prevalence of measles among pre-immunized children admitted to a hospital, analyzing factors such as age group distribution, clinical manifestations, and outcomes. Measles remains a significant public health concern, especially in settings with low immunization rates. Understanding the prevalence of measles among pre-immunized children in hospitals provides insights into the disease's persistence and the potential gaps in immunization coverage. Materials and methods: The study spanned for 1 year from 01/6/2022 to 31/05/2023 in immunization OPD of Brajarambha UPHC in Cuttack district. Parents of the children were enquired  through structured questionnaire  regarding occurrence of measles or travel history to a high risk measles areas, and the treatment received for measles cases i.e. Vit A Prophylaxis and History of previous MMR immunisation (only 1st dose, only 2nd dose or both 1st and 2nd doses). Results: The findings revealed that a significant proportion of measles cases occurred in children who had received one or more doses of the measles vaccine. Table 1 summarizes the prevalence by age group. Children aged 0–5 years showed the highest positive rate for measles antibodies, with 93 (62.8%) cases, compared to 55 (37.2%) cases among children aged >5 years. This difference was not statistically significant (P > 0.46). Additionally, it was concerning that some vaccinated children also tested positive for measles virus infection, raising questions about the effectiveness of vaccination or other underlying factors Conclusion: Measles in pre-immunized children underscores the importance of ensuring complete immunization schedules, timely booster doses, and maintaining high herd immunity. Further studies are needed to investigate vaccine efficacy and immunity durability in different populations

Background: Displaced midshaft clavicle fractures are traditionally managed conservatively, but recent evidence suggests better outcomes with surgical interventions. This study evaluates the union rates and functional outcomes in patients treated with Threaded Titanium Elastic Screw Nails (TTESN) compared to conservative management ( as per recent literature) Methods: A prospective analytical study was conducted on 41 patients with displaced midshaft clavicle fractures at a tertiary care centre from December 2022 to June 2024. Patients underwent surgical fixation with TTESN, and functional outcomes were assessed using the Constant Murley Score (CMS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score over 24 weeks. Complications, union rates, and radiological outcomes were recorded and analysed. Results: The mean union time was 10.87 weeks, with 93% of fractures achieving union within 12 weeks. CMS improved significantly from 21.07 ±3.26 preoperatively to 90.70 ±11.48 at 24 weeks (p < 0.0001). DASH scores decreased from 87.99 ±1.76 preoperatively to 5.86 ±11.27 at 24 weeks (p < 0.0001). Complications included nail breakage (10%), delayed union (7.5%), Brachial plexus injury (2.50%) ,  infection (2.43%) [patient was lost to follow up following removal of implant] with all fractures uniting by 24 weeks. Conclusion: TTESN is a safe and effective treatment for displaced midshaft clavicle fractures, providing superior union rates and functional outcomes with minimal complications.

Background: Parenting children with disabilities or chronic illnesses is associated with increased stress, but comparative studies focusing on the specific challenges faced by these groups remain limited. This study aims to compare the stress levels and coping mechanisms of parents of mentally retarded children to those of children with chronic medical illnesses. Methods: This cross-sectional study involved 143 parents (71 parents of children with mental retardation and 72 parents of children with chronic medical conditions). Data were collected using standardized instruments to measure stress and coping mechanisms. The statistical analysis involved Z-tests to compare mean scores and chi-square tests for distribution differences. Results: The results revealed that parents of children with mental retardation reported significantly higher stress levels (mean = 6.5, SD = 1.2) compared to parents of children with chronic medical conditions (mean = 5.9, SD = 1.1), with a statistically significant difference (P < 0.05). Similarly, coping scores were higher among parents of mentally retarded children (mean = 5.7, SD = 0.9) than those with chronic medical conditions (mean = 5.3, SD = 0.8), indicating more robust coping strategies in the former group (P < 0.05). Conclusion: The study underscores significant disparities in stress levels and coping mechanisms between parents of children with mental retardation and those with chronic medical conditions. These findings highlight the need for targeted psychological interventions and support systems tailored to the unique challenges faced by these parent groups to mitigate stress and enhance coping efficacy.

Background: Hypertensive disorders of pregnancy including preeclampsia, eclampsia, and gestational hypertension are leading causes of maternal and neonatal morbidity and mortality. These conditions can lead to fetal complications such as growth restriction, premature birth, and stillbirth. The current study aimed to explore the outcomes of babies born to mothers with hypertensive disorders. Methods: Patients were selected from the ANC clinical visits based on the inclusion and exclusion criteria. Maternal data included the demographic profile of women's types of hypertensive disorder, gestational age at the diagnosis of hypertension, gestational age at delivery, mode of delivery (vaginal, cesarean), use of antihypertensive medications (specify types and dosages if possible) The neonatal data recorded includes birth weight, Apgar scores (at 1 and 5 minutes), Gestational age at birth, sex of the baby, Neonatal complications. Results: A total of 100 mother-baby pairs were included. A substantial proportion of the babies (43%) were classified as small for gestational age or exhibiting intrauterine growth restriction (SGA/IUGR), while 57% were appropriate for gestational age (AGA). Most IUGR cases were asymmetrical (76.7%), suggesting placental insufficiency as a likely contributing factor. Importantly, the study found a significant association between IUGR and preterm birth, with 90.7% of IUGR babies being born preterm (p<0.001). All term IUGR babies exhibited asymmetrical growth restriction. Neonatal complications were common. 20% of babies developed respiratory distress syndrome (RDS), 13% experienced birth asphyxia, and 13% developed sepsis. Meconium aspiration syndrome (MAS) was less frequent, affecting 2% of the newborns. Conclusion: Pregnancy-induced maternal hypertension causes changes to the placenta, which can lead to problems for the developing baby. Poor management of preeclampsia is a major cause of fetal morbidity and mortality. Babies born to moms with hypertension have a higher risk of developing several issues, so it's important to keep a careful eye on them to ensure they have a better chance of surviving and growing up well. Low birth weight and premature delivery are the leading causes of perinatal mortality among these infants.