Background: Malnutrition is a critical determinant of surgical outcomes, yet its burden remains underrecognized in patients undergoing major abdominal procedures. Early nutritional risk identification may improve postoperative prognosis. Objectives: To evaluate the nutritional status of patients undergoing major abdominal surgery and to analyze its impact on postoperative morbidity and mortality. Methods: This prospective observational study included 200 adult patients undergoing elective major abdominal surgeries over 3 months. Nutritional status was assessed using Subjective Global Assessment (SGA), Body Mass Index (BMI), and serum albumin levels. Postoperative outcomes including surgical site infections, wound dehiscence, respiratory complications, length of stay, reoperation, and 30-day mortality were documented. Associations were analyzed using Chi-square test and multivariate logistic regression. Results: Of the 200 patients (mean age 54.6 ± 12.4 years), 61% were classified as malnourished (SGA B or C), and 41% had serum albumin <3.0 g/dL. Malnourished patients had significantly higher rates of surgical site infections (30.3% vs. 11.5%, p<0.001), respiratory complications (17.2% vs. 7.7%, p=0.03), and prolonged hospitalization (48.4% vs. 17.9%, p<0.001) compared to well-nourished individuals. Multivariate analysis confirmed malnutrition (OR 2.6; 95% CI: 1.5–4.8; p<0.001) and hypoalbuminemia (OR 2.4; 95% CI: 1.4–4.2; p=0.002) as independent predictors of adverse outcomes. Conclusion: Malnutrition and hypoalbuminemia are highly prevalent among patients undergoing abdominal surgery and are strongly associated with increased postoperative complications and mortality. Routine nutritional screening and optimization should be integrated into preoperative care.

Background: Anastomotic leak remains one of the most serious complications following gastrointestinal (GI) surgery, associated with increased morbidity, prolonged hospitalization, and mortality. Identifying modifiable risk factors is essential for optimizing perioperative care and improving outcomes. Aim: To determine the incidence of anastomotic leaks and evaluate associated clinical and perioperative risk factors among patients undergoing gastrointestinal anastomosis. Materials and Methods: A prospective observational study was conducted on 180 patients who underwent various types of GI anastomosis at a tertiary care center. Demographic data, surgical details, biochemical parameters, and postoperative outcomes were recorded. Anastomotic leaks were identified clinically and radiologically. Statistical analysis was performed using chi-square and Fisher's exact tests to determine the association between variables and leak occurrence. Results: The mean age of the patients was 52.6 ± 13.4 years, with a male predominance (60.5%). The overall anastomotic leak rate was 15% (27/180). The highest leak rates were observed in esophagojejunal (22.7%) and colorectal anastomoses (22.2%). Factors significantly associated with anastomotic leak included age > 60 years (p=0.02), emergency surgery (p<0.001), hypoalbuminemia (p<0.001), operative time >180 minutes (p=0.001), diabetes mellitus (p=0.01), and preoperative anemia (p=0.002). The median time to leak detection was 5 days, with fever (81%) and feculent drain output (41%) being common clinical indicators. Conservative management was successful in 51.9% of cases, while reoperation was required in 48.1%. Patients with leaks had a significantly longer hospital stay (16.4 ± 4.8 days) and higher mortality (22.2%) compared to the non-leak group. Conclusion: Anastomotic leak remains a critical postoperative complication in GI surgery. Advanced age, poor nutritional status, prolonged operative time, and emergency procedures are key contributors. Early detection and prompt management are essential to reduce adverse outcomes. Preoperative risk stratification and optimization may play a pivotal role in improving patient safety.

Background: The long-term high blood pressure is a major risk factor for coronary artery disease, stroke, heart failure and other comorbidities Materials and Methods:  A total of 80 subjects (Control-40; Hypertensive-40) with ages ranging from 35 to 50 years were selected at random using the random sample technique. These subjects had blood pressure readings between 130/90mmHg to 160/100 mmHg are considered hypertensive. The study was conducted in Department of Physiology, Kurnool Medical College. A standard sphygmomanometer was used to measure and routinely monitor the blood pressure levels of hypertensive subjects.  Results: The blood pressure level in experimental group was 0(0%) had normal blood pressure, 8(20.0%) had Pre-hypertension, 22(55%) had stage-1 hypertension, 10(25.00%) had stage- 2 hypertension whereas in control group 0(0%) had normal blood pressure level, 11(27.5%) had pre hypertension, 21(52.5%) had stage-1 hypertension, 10(25%) had stage-2 hypertension in the pre-Test. In the Post-test, the blood pressure level in experimental group was 8 (20.00%) had normal blood pressure, 17(42.5%) had Pre-hypertension, 15(37.5%) had stage-l hypertension, 0(0.00%) had stage-2 hypertension and in control group 4(10.00%) had normal blood pressure, 8(20%) had Pre -hypertension, 22(55%) had stage-1 hypertension, 6(15%) had stage-2 hypertension. The mean score on blood pressure level in experimental group was 3.01 in pre-test and 1.70 in post-test. In control group the mean score on blood pressure level was 2.96 in pretest and 2.83 in post-test among subjects with hypertension. The mean score of blood pressure level in experimental group was 1.70 in post-test and 2.83 in control group post-test. The estimated value was 5.16 among subjects with hypertension Conclusion: The current study suggests that regular practice of yoga could be helpful with significant reduction in blood pressure level in patients with hypertension and its associated comorbidities.

Background: Surgical site infections (SSI) are among the most common postoperative complications, particularly following gastrointestinal surgeries. They significantly contribute to increased morbidity, prolonged hospital stay, and healthcare costs. This study aimed to assess the prevalence and outcomes of SSIs in patients undergoing gastrointestinal surgeries. Methods: A hospital-based cross-sectional study was conducted on 100 patients who underwent elective or emergency gastrointestinal surgeries. Data on demographic profile, type of surgery, occurrence and classification of SSIs, and postoperative outcomes were collected and analyzed. SSIs were diagnosed based on CDC criteria. Outcomes assessed included length of hospital stay, reoperation, and mortality. Results: Among 100 patients, 62% were males and 50% were aged above 50 years. The prevalence of SSI was 18%. Superficial incisional SSIs were the most common (61.1%), followed by deep incisional (22.2%) and organ/space infections (16.7%). SSI rates were higher in open surgeries (23.3%) compared to laparoscopic surgeries (10%). Patients with SSIs had significantly longer hospital stays (14.6 ± 4.2 vs. 7.4 ± 2.5 days, p < 0.001). Reoperation was required in 11.1% of SSI cases, and mortality was observed in 5.6% of them. Conclusion: The study demonstrates a notable prevalence of SSIs in gastrointestinal surgeries, with open procedures posing a higher risk. SSIs are associated with adverse outcomes including extended hospitalization, increased reoperation rates, and mortality. Enhanced infection control practices and preference for minimally invasive techniques may help reduce the incidence and burden of SSIs.

Background: Buccal mucosal graft (BMG) urethroplasty is a widely adopted technique for managing anterior urethral strictures, offering good tissue compatibility and surgical versatility. However, clinical outcomes vary depending on stricture complexity, length, and surgical approach. Objective: To assess the clinical outcomes, complication profile, and recurrence rates of BMG urethroplasty in anterior urethral strictures over a one-year period in a tertiary care centre in South India. Methods: n This prospective observational study included 45 male patients (aged 20–67 years) undergoing BMG urethroplasty at a tertiary centre in Vijayawada, Andhra Pradesh. Grafts were placed using dorsal (71%) or ventral (29%) onlay techniques. Outcome measures included maximum urinary flow rate (Qmax) at 3, 6, and 12 months; stricture recurrence; need for reintervention; and donor site morbidity. Results: The mean stricture length was 3.9 ± 1.4 cm, with bulbar strictures being most common (60%). Mean Qmax improved from 7.2 mL/sec preoperatively to 15.5 mL/sec at 12 months, with earlier improvements noted at 3 months. At 12 months, the success rate was 55.6%, while recurrence occurred in 44.4% and reintervention was needed in 26.7%. Donor site morbidity was minimal, with 50% reporting no pain and 10% reporting moderate discomfort. Infection (11%) was the most common complication, followed by bleeding (7%) and one case of graft loss (2%). Conclusion: BMG urethroplasty offers functional improvement with acceptable morbidity in anterior urethral stricture repair. However, recurrence remains a significant concern, particularly in patients with longer or pan-anterior strictures. These findings highlight the need for individualized surgical planning, careful patient selection, and structured long-term follow-up.

Background: Pediatric dermatoses constitute a significant proportion of outpatient visits, especially in developing countries where environmental and socioeconomic factors play a key role. Objective: To assess the spectrum of pediatric dermatoses and their associations with age, gender, and socioeconomic status at a tertiary care center in Andhra Pradesh. Methods: A cross-sectional observational study of 381 children under 12 years presenting with dermatological complaints at SVRRGG Hospital, Tirupati. Data were analyzed using SPSS v21. Results: The majority of cases (30.4%) were aged 6–10 years. Females (59.1%) were more affected than males (40.9%). Most children belonged to lower middle (52.2%) or upper lower (38.6%) socioeconomic classes. Inflammatory dermatoses (29.7%) and fungal infections (17.6%) were most common. Notably, infestations and infections together accounted for 38.6%. Conclusion: Pediatric dermatoses predominantly affect children from lower socioeconomic strata and highlight the need for awareness, hygiene education, and early medical access.

Background: Flossing is a key oral hygiene practice for preventing interdental plaque accumulation and maintaining periodontal health. However, disparities in knowledge and usage between urban and rural populations remain underexplored. Aim: To assess and compare the knowledge and practice of flossing techniques among urban and rural populations. Materials and Methods: This cross-sectional comparative study included 400 participants (200 urban, 200 rural) selected through stratified random sampling. A validated 20-item questionnaire assessed awareness, knowledge, and flossing habits. Data were analyzed using SPSS version 25.0, with p < 0.05 considered significant. Results: Awareness of dental floss was significantly higher in urban participants (72.5%) than rural (36%) (p < 0.001). Daily flossing was reported by 28.5% of urban and only 10.5% of rural participants. The mean knowledge score was higher in the urban group (13.8 ± 3.2) compared to rural (8.1 ± 3.9) (p < 0.001). Dentists were the primary source of information in urban areas, while rural participants relied on informal sources. Conclusion: There is a significant disparity in knowledge and practice of flossing between urban and rural populations. Targeted oral health education and improved access to dental care are essential, especially in rural settings, to promote effective flossing practices..

Background: Isolation is a critical component of dental procedures, ensuring moisture control, patient safety, and optimal outcomes. Despite formal training, the consistent use of proper isolation methods among undergraduate dental students is often lacking. Aim: To evaluate the knowledge, attitude, and practice (KAP) of isolation techniques among undergraduate dental students during clinical procedures. Materials and Methods: A cross-sectional questionnaire-based study was conducted among 150 undergraduate students in the clinical phase of dental education. A validated survey assessed their knowledge, attitudes, and clinical application of various isolation methods. Data were analyzed using descriptive statistics and chi-square tests for association. Results: 78% of students showed moderate to high knowledge, with interns scoring highest. While 65% agreed that isolation improves treatment quality, only 32% routinely used rubber dams. Cotton rolls and suction were more frequently employed. A significant correlation was found between knowledge level and actual use of rubber dams (p < 0.05). Conclusion: Although students recognize the importance of isolation, its clinical application remains limited due to perceived barriers and inadequate practical exposure. Strengthening hands-on training and reinforcing isolation techniques during clinical rotations is essential to improve adoption and ensure procedural quality.

Background: Neonatal sepsis remains a leading cause of morbidity and mortality in developing countries, with variable prevalence rates across different healthcare settings [1][2]. Early identification of risk factors is crucial for implementing preventive strategies and improving neonatal outcomes [3]. Objective: To determine the prevalence and identify risk factors associated with neonatal sepsis in a tertiary care hospital in Jaipur, India. Methods: A prospective cross-sectional study was conducted from January 2024 to March 2024 at the National Institute of Medical Sciences & Research, Jaipur [4]. All neonates admitted to the neonatal intensive care unit (NICU) during the study period were evaluated for sepsis based on clinical presentation, laboratory parameters, and blood culture results [5][6]. Results: Among 240 neonates studied, 97 (40.4%) developed sepsis, with early-onset sepsis comprising 68 cases (70.1%) and late-onset sepsis 29 cases (29.9%) [7]. Blood culture was positive in 33 cases (34.0%), with Klebsiella pneumoniae being the most common pathogen (45.5%) followed by coagulase-negative Staphylococcus (21.2%) [1][3]. Significant risk factors included prematurity (62.5%), low birth weight (57.9%), and prolonged rupture of membranes >18 hours (9.2%) [8][9]. The overall mortality rate was 6.7%, with sepsis-related mortality at 16.5% [10]. Conclusion: Neonatal sepsis showed high prevalence in our tertiary care setting, predominantly affecting preterm and low birth weight infants [4][7]. Implementation of targeted prevention strategies focusing on identified risk factors could significantly reduce sepsis incidence and improve neonatal outcomes [11].

Background: Pancytopenia is a condition in which there is a lower-than-normal number of red and white blood cells and platelets in the blood. Pancytopenia occurs when there is a problem with the blood-forming stem cells in the bone marrow. Signs and symptoms include fatigue, weakness, dizziness, trouble breathing, fast heartbeat, fever, pale skin, purple or red spots on the skin, rash, easy bruising, and abnormal bleeding. Our aim is to study the various causes of pancytopenia in our region and assess the haematological and bone marrow findings in various cases of pancytopenia. Materials and Methods: The study is of prospective and analytical type, conducted on patients attending opd and ipd. All the cases irrespective of age and sex with pancytopenia were included in this study. Peripheral smear was used for morphological classification and typing of anemia. Bone marrow aspiration was then carried out under all aseptic precautions and slides were stained with leishmans stain. Cytochemistry was done using MPO stain and PAS stain were performed where necessary. Significant parameters like aetiology, age, gender, clinical features, hematological parameters, peripheral blood film, bone marrow aspiration findings in different cases of pancytopenia were compared with various studies published in literature. Results: A detailed peripheral blood smear examination was done on all patients. Megaloblastic anemia had 28 cases, 11 patients of acute leukemia immature cells, aplastic anemia had total 5 cases. The commonest bone marrow finding was megaloblastic anaemia 28(52.8%), followed by acute leukemia 11(20.8%) and normoblastic erythroid hyperplasia 6(11.3%), aplastic anaemia5(9.4%) other causes were mixed nutritional anaemia, multiple myeloma and Non hodkins lymphoma all had 1(1.9%) case each. Conclusion: In our country main cause of pancytopenia being fortunately megaloblastic anaemia which responds very well to treatment if diagnosed correctly in time. The present study concludes that detailed haematological investigations along with bone marrow examination in cytopenic patients are not only helpful in understanding the disease process but also to diagnose or to rule out the causes of pancytopenia and planning further investigations and management of these patients.

Background: Endometrial Intraepithelial Neoplasia (EIN) is a clonal proliferation of architecturally and cytologically altered premalignant endometrial glands which are prone to malignant transformation to endometrioid (Type I) endometrial adenocarcinomas. Our aim is to study the incidence of endometrial intraepithelial neoplasia in patients with history of abnormal uterine bleeding. Materials and Methods: The study is of prospective and analytical type, conducted on 80 patients with history of abnormal uterine bleeding who attended outpatient and inpatient department of Obstetrics and Gynaecology. These cases were then analysed considering the criteria laid down for diagnosis and classification of endometrial hyperplasia by WHO classification of endometrial hyperplasia. Statistical analysis was carried out using descriptive and inferential statistics using chisquare test. Results: The incidence of endometrial intraepithelial neoplasia which is a premalignant condition was more in atypical hyperplasia. This was more common in perimenopausal and postmenopausal age group. Hence, histopathological evaluation of the endometrium is specially recommended in women with these age groups, presenting with abnormal uterine bleeding in order to rule out the possibility of premalignant condition. Conclusion: The sensitive and accurate diagnosis of true premalignant endometrial lesions can reduce the likelihood of developing invasive endometrial cancer.

Background: Indoor air pollution is a significant but under-recognized contributor to pediatric respiratory morbidity. School-aged children, who spend substantial time indoors, are particularly vulnerable to air quality deterioration. Objectives: To assess indoor air quality (IAQ) parameters and examine their association with respiratory symptoms among school-aged children. Methods: A cross-sectional study was conducted among 100 children aged 6–12 years residing in urban households. Indoor concentrations of particulate matter (PM₂.₅), carbon dioxide (CO₂), temperature, and humidity were measured using standardized monitors. Respiratory symptoms including cough, wheezing, nasal congestion, and shortness of breath were recorded using a structured parental questionnaire. Chi-square tests and multivariate logistic regression were used to examine associations between pollutant levels and respiratory outcomes, adjusting for age, gender, household smoking, and use of biomass fuel. Results: PM₂.₅ and CO₂ levels exceeded WHO-recommended indoor limits in 78% and 62% of households, respectively. At least one respiratory symptom was reported in 61% of children, with nasal congestion (41%) and cough (38%) being the most common. Significant associations were observed between high PM₂.₅ and increased respiratory symptoms (χ² = 16.34, p < 0.001), and between high CO₂ and breathlessness/wheezing (χ² = 6.12, p = 0.013). Multivariate analysis confirmed elevated odds for respiratory symptoms in children exposed to high PM₂.₅ (OR = 2.83; p = 0.003) and CO₂ (OR = 2.11; p = 0.045). Conclusion: Poor indoor air quality, particularly elevated PM₂.₅ and CO₂ levels, is significantly associated with increased respiratory symptoms among children. Targeted indoor air improvement strategies are essential for respiratory health promotion.

Background: Airway management in patients with restricted neck mobility, such as those with cervical spine immobilization, is often associated with reduced safe apnoea time and rapid oxygen desaturation. Apnoeic oxygenation using nasal prongs is a simple, non-invasive technique that may enhance oxygenation during laryngoscopy. Aim: To evaluate the effectiveness of nasal prongs in maintaining oxygen saturation during apnoea in patients with simulated cervical spine immobilization. Methods: This prospective, randomized, double-blind study was conducted on 60 ASA I–II patients aged 18–60 years scheduled for elective surgery. Patients were randomized into two groups: Group P (preoxygenation alone) and Group PN (preoxygenation with nasal prong oxygenation at 5 L/min during apnoea). Apnoea was simulated using manual in-line stabilization and oropharyngeal airway. Arterial blood gases and SpO₂ levels were recorded before and after apnoea. Results: Group PN had significantly longer apnoea time (339.03 ± 35.24 sec) compared to Group P (269.73 ± 72.82 sec, p < 0.001). Post-apnoea PaO₂ and SpO₂ were significantly higher in Group PN. Haemodynamic parameters remained stable. Conclusion: Nasal prongs effectively prolong the duration of safe apnoea and improve oxygenation during difficult laryngoscopy scenarios without adverse haemodynamic effects.

Background: Airway management in patients with cervical spine immobilization is clinically challenging due to restricted neck movement. Supraglottic airway devices (SADs) such as the Intubating Laryngeal Mask Airway (ILMA) and I-GEL offer a conduit for fiberoptic-guided intubation without cervical manipulation. Aim: To compare the efficacy of I-GEL and ILMA as conduits for fiberoptic endotracheal intubation in patients with simulated cervical spine immobilization. Methods: A randomized, prospective study was conducted on 150 ASA I–II patients undergoing elective surgery under general anaesthesia. Participants were allocated into two groups (n = 75 each): Group I-GEL and Group ILMA. Both groups were assessed for first-attempt success rate, time and number of attempts for SAD insertion and intubation, and complications. Results: First-attempt fiberoptic intubation was successful in 98.6% of patients in the I-GEL group and 94.7% in the ILMA group (p = 0.367). Mean time for SAD insertion was significantly shorter in the I-GEL group (20.3 s vs. 25.59 s; p < 0.05). No major complications were observed. Conclusion: Both I-GEL and ILMA are effective as conduits for fiberoptic intubation under cervical spine immobilization, with I-GEL showing advantages in insertion time and ease of use.

Background: Non-adherence to antihypertensive therapy remains a major barrier to effective blood pressure control among patients with chronic hypertension. Understanding the factors influencing adherence can guide targeted interventions to improve clinical outcomes. Objectives: To assess the level of medication adherence and identify its key determinants among patients diagnosed with chronic hypertension. Methods: A cross-sectional observational study was conducted among 100 patients with chronic hypertension attending outpatient services at a tertiary care center. Data were collected using a pretested semi-structured questionnaire and the 8-item Morisky Medication Adherence Scale (MMAS-8). Demographic characteristics and clinical factors were analyzed using descriptive and inferential statistics to identify associations with adherence levels. Results: The mean age of participants was 56.4 ± 10.2 years; 58% were female, and 62% resided in urban areas. Medication adherence levels were high in 29%, medium in 45%, and low in 26% of patients. Statistically significant determinants of adherence included educational status (p = 0.01), duration of hypertension (p = 0.04), polypharmacy (p = 0.03), comorbidities (p = 0.02), and quality of doctor-patient communication (p = 0.001). Among those with medium or low adherence (n = 71), primary reasons for non-adherence were forgetfulness (48%), side effects (22%), financial constraints (18%), and feeling well without medication (12%). Conclusion: Medication adherence among patients with chronic hypertension was suboptimal. Educational status, disease duration, comorbidities, and effective communication with healthcare providers significantly influenced adherence. Tailored interventions addressing these factors are essential for improving treatment outcomes.

Background: Hip fractures in polytrauma patients present unique diagnostic and management challenges, especially in high-volume tertiary care centers. Early identification is crucial for optimal outcomes. Objective: To determine the incidence, prevalence, and clinical patterns of hip fractures in polytrauma cases and to evaluate associated outcomes. Methods: A retrospective study was conducted over five years (2019–2023) at a tertiary care hospital. Polytrauma cases with Injury Severity Score (ISS ≥16) were reviewed. Patients with radiologically confirmed hip fractures were included. Data were collected on demographics, injury mechanisms, fracture types, associated injuries, treatment modalities, and outcomes. Statistical analysis was performed using SPSS v26. Results: Of 1,132 polytrauma cases, 147 (13.0%) sustained hip fractures. The majority were males (56.5%) with a mean age of 54.8 ± 18.3 years. Intertrochanteric fractures (46.9%) were most common, with road traffic accidents accounting for 74.1% of injuries. Hip fractures were significantly associated with increased ICU admissions (p=0.002), prolonged hospital stay (p<0.001), surgical intervention (p<0.001), and higher 30-day mortality (p=0.001). Conclusion: Hip fractures are prevalent in polytrauma patients and are linked to worse short-term outcomes. Prompt orthopedic assessment and early surgical management are critical to improving recovery and reducing complications.

Introduction: The interplay between dermatological conditions and bone health has gained increasing attention in recent years. Chronic inflammatory skin diseases, vitamin D metabolism alterations, and medications used in dermatology can significantly impact bone metabolism. This study explores the mechanisms linking skin disorders to bone health deterioration. Materials and Methods: A cross-sectional study was conducted among patients diagnosed with chronic dermatological conditions such as psoriasis, atopic dermatitis, and systemic sclerosis. Bone mineral density (BMD) was assessed using DEXA scans. Patients were categorized by skin disease type and severity. Exclusion criteria included pre-existing metabolic bone diseases, malignancies, and medications affecting bone metabolism. Results: The mean age of participants ranged from 35.6 to 45.2 years across disease groups. The psoriasis and systemic sclerosis groups had a higher proportion of males, whereas atopic dermatitis (AD) and systemic lupus erythematosus (SLE) groups were predominantly female. Systemic sclerosis patients showed the highest prevalence of both osteopenia (50%) and osteoporosis (30%), followed by SLE and psoriasis. In contrast, only 10% and 2% of controls had osteopenia and osteoporosis, respectively. Vitamin D deficiency was notably more common in patients with skin diseases,   Conclusion: Dermatological conditions contribute to bone loss through chronic inflammation, drug side effects, and nutritional deficiencies. Early screening and targeted interventions are essential to mitigate osteoporosis risk in these patients.

Background: Postoperative nausea and vomiting (PONV) is a common complication following laparoscopic surgeries, impacting patient recovery and satisfaction. This study compares the efficacy of intravenous palonosetron versus intravenous ondansetron in preventing PONV in patients undergoing laparoscopic procedures. Objective: To assess the effectiveness of 75 mcg of palonosetron compared to 4 mg of ondansetron in preventing PONV and evaluate the associated side effects. Methods: A total of 180 patients undergoing laparoscopic surgery were randomly assigned to receive either 75 mcg of palonosetron (Group B) or 4 mg of ondansetron (Group A). Key measurements included blood pressure, heart rate, Visual Analog Scale (VAS) scores for nausea, vomiting, and 4-point severity scores over 24 hours post-surgery. Statistical analysis was conducted using t-tests to assess significant differences between the groups. Results: The findings indicated that palonosetron (Group B) demonstrated significantly lower VAS and 4-point severity scores for nausea and vomiting compared to ondansetron (Group A) at all post-surgery time points (2, 6, 12, and 24 hours). Group B also exhibited more stable hemodynamic parameters, with significantly lower heart rate and blood pressure fluctuations than Group A. Conclusion: Palonosetron is more effective than ondansetron in preventing PONV in patients undergoing laparoscopic surgeries, providing better control over postoperative symptoms with a more favorable side effect profile.

Background: This study aimed to develop and evaluate an artificial intelligence (AI) model to enhance diagnostic accuracy in detecting dental conditions from radiographs and patient data. Given the challenges of accurately interpreting dental radiographs, this research addresses the need for improved diagnostic support in dental practices. Methods: A convolutional neural network (CNN) was trained using a dataset of panoramic and periapical radiographs, encompassing conditions such as dental caries, periodontitis, and periapical lesions. Data preprocessing techniques and data augmentation were applied to improve model generalizability. Model performance was assessed using metrics such as accuracy, sensitivity, specificity, and AUROC, and was compared to diagnostic accuracy by human practitioners. Results:

The CNN model achieved an accuracy of 92.3%, with sensitivity and specificity exceeding 90% across most dental conditions. When compared to experienced dental practitioners, the model showed higher diagnostic accuracy and processing speed, taking approximately 2.3 seconds per image. Despite occasional misclassifications, particularly with lower-quality images, the model demonstrated robust diagnostic capability. Conclusions: The AI model developed in this study offers a reliable tool to assist dental professionals by enhancing diagnostic precision and efficiency. While challenges remain, particularly in cases of poor image quality, the model holds promise as a supplementary diagnostic aid, especially in high-demand clinical settings. Future research should focus on incorporating multi-modal data and real-time diagnostic capabilities. Clinical Relevance: AI-assisted diagnosis in dental radiography can reduce diagnostic errors and enhance workflow efficiency, particularly in areas with limited access to specialized dental practitioners.

Introduction Outreach dental camps play a vital role in addressing oral health disparities in underserved populations, particularly in slum areas of metropolitan cities where access to dental care is limited. Objective: This study aims to evaluate the effectiveness of outreach dental camps conducted in slum areas of a metropolitan city over the past five years. Methods: A retrospective analysis of data from 20 dental camps held between 2018 and 2023 was performed. Key outcomes included the prevalence of dental diseases, treatments provided, and participant satisfaction. Results: Of 5,000 individuals screened, 68% required dental treatment, with dental caries (41%) and periodontal disease (30%) being most prevalent. Treatment uptake was 85%, with high participant satisfaction (93%). Conclusion: Outreach dental camps are effective in improving access to oral healthcare in slum areas, addressing significant unmet needs. However, sustainable interventions and follow-up care are essential for long-term impact.

Introduction Electronic Health Records (EHR) have revolutionized data management and patient care in healthcare, including dentistry. The implementation of EHR in dental practice facilitates comprehensive documentation, improves clinical efficiency, and enhances patient safety through better recordkeeping and decision support. Despite its advantages, EHR adoption in dentistry faces challenges such as interoperability issues, data security concerns, and high implementation costs. Objective This systematic review aims to evaluate the impact of EHR adoption in dentistry by examining its benefits, challenges, and future trends. The review also assesses the role of emerging technologies in enhancing EHR functionality and integration with general healthcare systems. Methods A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library for studies published between 2010 and Jan 2024. The search strategy included a combination of MeSH terms and free-text keywords. Studies focusing on EHR implementation, usability, efficiency, and associated challenges in dental practice were included. Data extraction was performed systematically, and quality assessment tools such as the Cochrane Risk-of-Bias tool, Newcastle-Ottawa Scale, and AMSTAR-2 were applied. Data synthesis involved qualitative analysis, with meta-analysis conducted where applicable. Results A total of 45 studies were included, comprising RCTs (10), observational studies (18), systematic reviews (7), and qualitative studies (10). The findings revealed that EHR adoption significantly improves clinical efficiency, patient data management, and interdisciplinary communication in dentistry. However, challenges persist, including interoperability limitations, cybersecurity threats, financial constraints, and user resistance. Emerging technologies such as AI-driven decision support, cloud-based EHR systems, and blockchain security solutions are promising advancements for overcoming these challenges. Conclusion EHR systems play a critical role in modern dentistry, offering numerous benefits in efficiency, accuracy, and patient safety. However, barriers such as high implementation costs, poor interoperability, and cybersecurity concerns hinder widespread adoption. Standardization of dental EHRs, AI integration, and government incentives are essential for improving EHR utilization. Future research should focus on developing cost-effective, interoperable, and secure EHR solutions tailored for dental practice.

Introduction: Fever is one of the most common occurring signs of illness during childhood. When a child has fevered all family members panic and want their child to get well as soon as possible. To reduce fever the approach of mothers differs according to their level of education and understanding. The study was conducted to determine knowledge about ever among mothers and to know their attitude and response. Material and methodsThe study consisted of 100 mothers with children 0-12 years of age who attended pediatric OPD of Ayaan Institute of Medical Science Hospital & Research Centre, Kankamidi Village, Moinabad Mandal, Ranga Reddy District, Telangana State. Data was collected using a questionnaire containing semi structured knowledge questionnaire. Results: In this Study 15% of mothers regarded temperature above 37°c as fever 85% belived fever is harmful for their children and 90% experienced fear and covered to their childs fever. About 10% mothers feared that their child would die due to fever. In response to ever around 30% used antifebrile drugs without consulting physican 60% used manual measuring method with their hands 20% of mothers used cold water for peripheral cooling. The level of fear among mothers about fever decreased as the level of education increased. Conclusion Proper and valuable information provided to mothers would prevent unnecessary minimize delayed and insufficient responses to fever.

Objective: This research aimed to comprehensively evaluate outcomes in kidney transplant recipients, specifically focusing on graft survival and complication rates. The primary objective was to identify demographic and clinical factors influencing these outcomes. Methods: A retrospective analysis was performed on 300 kidney transplant recipients, considering donor and recipient demographics, induction therapy, and post-transplant complications. Statistical analyses were employed to assess graft survival and complication rates. Results: At 1, 3, and 5 years, 90%, 80%, and 70% of grafts were still alive, respectively. Complications included surgical site infections (20%), acute rejection episodes (15%), and “New-Onset Diabetes After Transplantation [NODAT]” (10%). Notable associations were observed between donor age, recipient age, induction therapy, and delayed graft function with graft survival and complication rates. Conclusion: This research provides valuable insights into the factors influencing graft survival and complications in kidney transplant recipients. Key findings underscore the significance of donor-recipient characteristics, induction therapy choices, and prompt management of delayed graft function. These insights can inform personalized transplant strategies and enhance long-term outcomes in kidney transplant recipients. Future research should focus on refining risk stratification models and exploring innovative interventions to further optimize transplant success

Background: Artificial Intelligence (AI) is revolutionizing health sciences by enhancing diagnostics, predictive analytics, personalized medicine, and patient monitoring. Objective: This systematic review examines recent advancements in AI applications within healthcare. Methods: A comprehensive literature search was conducted across multiple databases, focusing on studies published between 2018 and 2023 that explored AI's role in health sciences. Inclusion criteria encompassed peer-reviewed articles employing AI techniques in diagnostics, predictive analytics, personalized medicine, or healthcare delivery. Results: In diagnostics, AI algorithms, particularly deep learning models, have achieved high accuracy in detecting diseases such as cancer and cardiovascular conditions. Predictive analytics powered by AI enable accurate forecasting of disease progression and treatment responses, facilitating proactive healthcare strategies. In personalized medicine, AI-driven models support the development of tailored treatment plans, improving patient outcomes. Additionally, AI integration into wearable devices and telehealth platforms enhances real-time health monitoring and remote consultations. Conclusion: AI is significantly transforming healthcare delivery and patient outcomes. However, challenges such as data privacy concerns, algorithmic biases, and the need for transparent AI models persist. Addressing these issues through interdisciplinary collaboration and robust ethical frameworks is essential for the responsible implementation of AI in healthcare.

Background Maxillary posterior rehabilitation is critical for restoring function and aesthetics. The choice of crown material—porcelain-fused-to-metal (PFM), all-ceramic, or zirconia—plays a pivotal role in determining clinical outcomes. Despite advancements in materials, the comparative performance of these crowns remains a topic of interest. Objective This study aims to compare the survival rates, complications, patient satisfaction, and cost-effectiveness of PFM, all-ceramic, and zirconia crowns in maxillary posterior rehabilitation. Methods A retrospective cohort study was conducted, analyzing clinical records of 150 patients treated with PFM (n = 50), all-ceramic (n = 50), and zirconia crowns (n = 50) over five years. Outcomes included survival rates, complication profiles (e.g., chipping, fracture, wear), patient satisfaction (measured using a 10-point Likert scale), and cost analysis. Statistical tests included Kaplan-Meier survival analysis, chi-square tests, and one-way ANOVA. Results Zirconia crowns exhibited the highest survival rate (90%) compared to PFM (85%) and all-ceramic crowns (82%) (p = 0.032). PFM crowns had the highest complication rates, particularly chipping (20%) and marginal discoloration (15%), while zirconia crowns showed minimal complications but caused wear on opposing teeth (10%). Patient satisfaction was highest for zirconia crowns (8.8 ± 1.0), followed by all-ceramic (8.4 ± 0.9) and PFM crowns (7.5 ± 1.2) (p = 0.045). Although zirconia crowns had the highest initial cost ($600), their long-term maintenance cost was the lowest ($50 over five years). Conclusion Zirconia crowns demonstrate superior performance in maxillary posterior rehabilitation, offering the best balance of durability, aesthetics, and patient satisfaction. All-ceramic crowns remain a viable choice for aesthetics-sensitive patients, while PFM crowns are a cost-effective but less durable option. Individualized treatment planning is essential for optimal outcomes.

Introduction The most prevalent form of the disease, type 2 Diabetes Mellitus is often asymptomatic in the early stages and it may remain undiagnosed for many years.The insulin resistance in the liver leads to failure of the hyperinsulinaemia to suppress the gluconeogenesis, which increases fasting glucose levels and decreases. glycogen storage by the liver in the postprandial phase. Increased glucose production in the liver occurs early in the course of diabetes, and it is likely in skeletal muscles after the onset of the insulin secretory abnormalities and the insulin resistance. Due to the insulin resistance in the adipose tissue and obesity, the free fatty acid (FFA) flux from the adipocytes is increased, which in turn leads to an increase in lipid [very low-density lipoprotein (VLDL) and triglycerides] synthesis in the hepatocytes. Materials and Methods This is a prospective and observational study was conducted in the Department of Biochemistry, Ayaan Institute of Medical Sciences Teaching Hospital & Research Centre. A newly diagnosed type 2 DM patients who attended the Medicine Département were included. Subjects were newly diagnosed type 2 DM patients aged 30 years and above. Patients with gestational DM, steroid-induced DM, thyroid disease or secondary dyslipidemia were excluded from the study. Demographic, clinical and laboratory data were retrieved from the case notes of patients who satisfied the eligibility criteria.  Results The study included 160 diabetic patients to evaluate the significance of postprandial dyslipidemia. Patients were categorized based on their glycemic status, lipid profiles, and postprandial lipid levels.  Postprandial dyslipidemia, characterized by elevated triglycerides and reduced HDL-C levels, was a significant finding in this study. These abnormalities were more pronounced in patients with poor glycemic control, highlighting the importance of postprandial lipid monitoring and its potential role in managing cardiovascular risk in diabetic patients Conclusion Postprandial dyslipidemia is prevalent among diabetic patients and is significantly associated with poor glycemic control. Monitoring postprandial lipid levels could be essential in managing cardiovascular risk in this population

Background: Autologous Hamstring Graft is one of the most commonly used graft for ACL reconstruction. However, harvesting autologous hamstring graft has a potential complication of weakening stabilisation of hip and knee. Moreover, recent usage of autologous peroneus longus graft gives an alternative option.

Methods: This is a prospective study conducted in a tertiary hospital centre in Naharlagun, India. A total of 53 eligible patients were selected and grouped into hamstring (n=24) group and peroneus longus (n=29) after randomisation using simple block chit technique. Out of which 26 patients in PL group completed the follow-up while 20 patients in hamstring group completed the study.

Results: In this study, out of 53 selected eligible patients 7 were lost to follow up.  A total of 20 hamstring group and 26 peroneus longus group completed the study. Randomisation was done using simple chit technique to assign patients to individual group. Among the study group 39 were males while 14 were females. As per the mode of injury, sports injury(10PL/9HS) was most common followed marginally by road traffic accidents (10/7) and self-fall (7/10). Regarding surgical site infection hamstring group was more common as compared to PL group.

Conclusion: PLT has a greater ultimate tensile load, more thickness and length, less graft harvesting time, and almost no donor site morbidity and has a good functional outcome of the knee, making it an effective and safe autograft option. So, PL autograft can be a promising graft of choice in the reconstruction of the ACL and can be much more beneficial in simultaneous multi-ligament injury repair in the knee joint

Background: Hemorrhoids are defined as an aberrant downward movement in the anal cushions that results in venous dilatation. Hemorrhoids are commonly associated with burning, itching, perianal discomfort, and bleeding. Aim: This paper aims to evaluate of hemorrhoid outcomes for pregnant women. Patients and methods: This paper was interested to evaluate of hemorrhoid outcomes for pregnant women where include patients who suffered of hemorrhoids in different hospitals in Iraq from 19^th July 2021 to 25^th June 2022. This paper was focused on patients who have ages in between 25-40 years. This paper was included to groups. Where the first represented the patients' group who still suffered of hemorrhoids after the process outcomes of the operative, while the second group presented patients who successes of prevent hemorrhoids where it, represented as intervention group with 164 cases where each group has 64 patients. The data were examined and recovered the outcomes of health outcomes by the SPSS program. Results and Discussion: According to our findings, either ITT or PP analyses revealed that this intervention reduced hemorrhoids by about 60% of the overall rate. The prevalence of hemorrhoids following giving birth for the patient’s category (ITT-41%; PP-42%) was consistent with Poskus et al.'s observed rate of 40.7% in a comparable population. Conclusion: Due to the comparatively low miscarriage as well as hemorrhoid rates, small variations between research groups might have been ignored. Yet, the miscarriage rate was the most recognized result for assessing the safety of different prenatal procedures. Finally, our proposed method, which aims to change dietary and behavioral patterns, dramatically lowers the risk of hemorrhoids throughout pregnancy and may be safely advised to pregnant women.

Background: There is a high rate of awareness during open heart surgery, which causes severe complications that endanger the patient's life and potentially lead posttraumatic stress disorder. Various techniques have been employed to measure the depth of anesthesia and awareness by Entropy (EEG, EMG monitoring) autonomic response (H.R, B.P), Bispectral index (EEG monitoring) skin conductance (change in sweat production), lower esophageal contractility. Aims: In our study we try to compare the incidence of awareness by measuring the difference in level of entropy) EEG) in these two groups of anesthetic drugs ,1st group Remifentanil, 2nd group propofol. Patients and methods: A randomized prospective comparative clinical trial, of 44 adult patients were undergone open heart surgery,22 of them received Remifentanil, the other 22 patients received propofol both as maintenance of anesthesia. Before induction of anesthesia, we apply three forehead entropy leads to measure the depth of anesthesia in the pre cardiopulmonary bypass period. Results: There was significant decrease in awareness (state entropy) in R group, P value 0. 016m.The H. R significantly decrease in P Group P value 0. 046.While there is no significant difference in blood pressure in both groups. Conclusion: The use of Remifentanil for maintenance of anesthesia in open heart surgery is more suitable than propofol maintenance because it has shown less awareness and more hemodynamic stability.

Introduction The incidences of allergy to general anesthetics ranges between 1/350 in IRAQ. The incidence of peranesthetic allergic reactions estimated in 2006 in IRAQ was 1/9000, all drugs confounded, and the incidence of allergic reactions to NMBA was evaluated to be 1/6500 anesthesia. Allergic reactions can be benign or fatal in some cases (6%).

Material and Methods A cross-sectional study was conducted on patients in different hospitals in Iraq, and 20 patients were collected. The study was devoted to knowing the Prevalence of patients allergic to general anaesthesia. Distributed patients according to age between 25 years to 50 years, and through the statistical analysis SPSS IBM SOFT mean value and SD was for age 33±6.1.

Results Positive results of the prick test It showed a high percentage of Meperidine for six patients, and positive results were distributed according to gender: 3 male patients and three female patients, and Morphine for four patients, according to sex (3 male patients and one female patient).

Conclusion Allergic reaction may be more severe in patients with asthma, heart disease, etc. Allergic reaction appears in most cases within minutes from the moment of exposure to the allergen.

Introduction Coeliac disease (CD) is a complex immune- mediated illness that is sparked by dietary gluten- sensitive enteropathy as well as progresses over time in genetically predisposed people susceptible persons during their lifetime.

Material and Methods Eighty-four Iraqi patients (Male & Female) with celiac disease with an age range (3-65) were investigated. Samples were taken from the Al Karama Teaching Hospital. Data sheet was filled according to questionnaire format, which include name, age, smoking, family history & alcohol intake. The patient's diagnosis was based on some serological test (AGA, tTG) the patients were clinically subdivided into treated and untreated.

Results In our study indicate that the majority of patients in celiac disease were diagnosed in females more than males; in the other hand, 66,67% of the confirmed treated Patients with celiac disease were females, while 33.33% were males, 40% confirmed untreated Patients from celiac disease were males when they were females 60 %, moreover furthermore 62.96% control female group more than 37.04% male control group with a significant difference (P-value 0.03661).

Conclusion Treated group Gluten-free diet (GFD) for celiac patients may be reduce the risk of Celica diseases in concentration and activity.

Introduction The hip is the second largest weight-bearing joint in the human body after the knee joint. It is a ball-and-socket type of synovial joint. The rounded head of the femur forms the ball, which fits into the acetabulum (socket in the pelvis). Various conditions have been attributed as etiological factors for avascular necrosis of the femoral head. The porous hydroxyapatite (HA) coated prosthesis used in uncemented total hip arthroplasty promotes healing, allowing bone to grow into or onto the prosthesis.

Methods This is a prospective study of clinical and radiological analysis of uncemented total hip arthroplasties performed for various hip disorders was carried out in Orthopaedics Department Tertiary Care Teaching Hospital. Patients diagnosed with osteoarthritis of hip joint with stage III & stage IV, who underwent uncemented total hip replacement are included in our study. All the patients were explained about the procedure, necessity for follow up and written consent was taken.

Results The age ranges from 32-60 years with mean age of 48.31years. Most of the cases are between the age group of 51 to 60 years constituting 46.88% of study population. Of the 32 cases included in the study majority are male patients.22 patients are male constituting 68.75% of cases and the rest 10 are female patients constituting 31.25% of the cases. The average pre operative Harris hip score (HHS) was 44.69. The Harris hip score at most recent follow up (1yr) was 84.2. The result was excellent in 9 patients, Good in 17 patients, fair in 6 patients. Mean HHS at each follow up visit was compared with pre operative HHS using Paired T test and p values were calculated. P value was found to be significant with each comparison.

Conclusions Our study supports the usage of uncemented THR in osteoarthritis in both young and elderly. The current trend, research and advent of new implants support uncemented THR in patients suffering from this crippling hip arthritis and avascular necrosis.