Background: The aim is to assess functional outcome of extra articular deformities corrected with intra articular corrections in primary total knee replacement. Materials and Methods: A prospective study was conducted over 18 months at Osmania General Hospital, Hyderabad, Telangana, India, involving 20 patients aged 50-70 years with extra- articular varus deformity of less than 20 degrees in the femur and less than 30 degrees in the tibia. Preoperative evaluations included sociodemographic details, blood investigations, imaging results, Knee Society scores, and Hungerford scores. Surgical corrections involved intra-articular bone resections and soft tissue release. Results: A majority of participants (75%) had their alignment fully corrected, and 85% reported advantages from the single-stage procedure. Radiological corrections were observed in varying degrees, with 50% of participants showing moderate improvement and 40% showing significant improvement. Notably, there were no reported complications, demonstrating the safety and efficacy of the interventions. The absence of complications and the high rates of alignment and radiological improvements reinforce the positive impact of the surgical procedures on the participants' health and quality of life. Conclusion: One-stage total knee arthroplasty is a viable and effective option for correcting extra-articular varus deformities, providing significant clinical and functional improvements while maintaining a favourable safety profile. Keywords: Functional outcome, Extra-articular varus deformities, Radiological corrections, Quality of life.

Background: Coronary artery disease is one of the leading causes of death globally, with coronary artery bypass grafting remaining the gold standard of treatment, especially in multivessel disease. However, diffuse disease poses an unforeseen difficulty of distal revascularisation by standard Coronary Artery Bypass Grafting (CABG) alone. Coronary endarterectomy as an adjuvant, even if unplanned preoperatively is essential in these cases for adequate revascularisation. In this study, we have compared the technical procedures and outcomes of coronary endarterectomy. Materials and Methods: In this retrospective observational study, we intend to compare the technique used, the vessel addressed and the outcomes recorded in patients who have undergone CABG with Coronary Endarterectomy at two separate tertiary care speciality hospitals between the period from February 2023 to February 2025, done by a single surgeon. Results: Data of 57 patients who had undergone CABG with coronary endarterectomy during the study period were analysed and assessed. There was a male preponderance in the study population, with the majority of patients falling in the 50 – 60-year age group. More patients underwent closed endarterectomy with off-pump or on-pump beating heart CABG while open endarterectomy was more common in on-pump arrested heart CABG. RCA was the most commonly endarterectomised vessel in our study. Conclusion: This study shows that successful coronary endarterectomy with CABG can show a drastic improvement in cardiac function and symptom relief of the patients due to improved perfusion and distal run off as the plaque causing obstruction is completely removed. However adequate postoperative anticoagulation and antiplatelet regimen as well as strict follow-up are necessary to ensure adequate maintenance of vessel patency and prevent reocclusion. Key Words: Coronary Artery Bypass Grafting, Coronary Endarterectomy, Coronary Artery Disease

Background: Student-centric teaching methods like Problem-Based Learning (PBL) and Small Group Discussions (SGD) focus on interactive, particularly beneficial in teaching clinical medical subjects. These methods help in developing diagnostic and decision-making skills which are essential in clinical practice. However, literature comparing the efficacy of these methods in undergraduate clinical teaching is limited. Materials and Methods: A quasi-experimental study was conducted among 124 final-year MBBS students at Dr Moopen’s Medical College, Wayanad, from October to December 2024. Students were divided into PBL (n=61) and SGD (n=63) groups based on roll numbers. Each group underwent three sessions on topics: Rickets, Osteosarcoma, and Osteomyelitis. Pre-tests and post-tests (MCQs) were used to assess knowledge gain and a Likert scale evaluated student perception. Data was analyzed using paired and unpaired t-tests with SPSS v26. A p-value < 0.05 was considered significant. Results: Pre-test scores were comparable between groups except for Osteomyelitis, where SGD scored higher (p=0.012). Both groups showed statistically significant improvements from pre- to post-test scores across all topics (p<0.001). Post-test comparisons between PBL and SGD revealed no significant differences between these two groups indicating both methods were equally effective. More than 90% of students reported improved understanding, engagement, critical thinking, and overall satisfaction with both methods. Conclusion: Both PBL and SGD are effective teaching-learning methods for clinical subjects in undergraduate medical education, promoting knowledge application to real-time clinical scenarios, and enhancing collaborative and problem-solving skills. Keywords: Problem Based Learning, Small Group Discussion, Medical education, Undergraduate teaching, Learning outcomes

Background: The aim is to establish the diagnostic usefulness of Delta Neutrophil Index as an early marker of disease severity in patients with acute pancreatitis. Materials and Methods: Single centre, non-interventional, prospective observational study in department of medicine for a period of 2 years in acute pancreatitis cases admitted diagnosed through clinical, laboratory and radiological parameters. Results: Mean heart rate was lesser in mild cases (79.20±9.7 bpm) compared to total population (85.05±12.1 bpm). This suggests that heart rate increases with severity of acute pancreatitis. Delta neutrophil index (DNI) had strong positive correlation with CRP, ANC, ATLANTA and BISAP scores , stronger correlation of DNI with severity was seen in mild cases compared to moderate-severe cases. Conclusion: DNI measured at presentation in emergency has the potential to function as an adjunctive marker for prediction of severity of acute pancreatitis. Keywords: Delta neutrophil index, Absolute neutrophil count , High sensitivity C reactive protein.

Background: Candida species have emerged as significant opportunistic pathogens, causing a wide spectrum of infections in hospitalized patients. The increasing prevalence of non-albicans Candida species along with rising antifungal resistance poses substantial challenges in clinical management. Aim and Objective: The present study aimed to determine the distribution of Candida species isolated from various clinical samples and to assess their antifungal susceptibility patterns in a tertiary care hospital setting. Materials and Methods: This observational study was conducted over a period of 18 months in a tertiary care hospital. Clinical samples such as blood, urine, respiratory secretions, vaginal swabs, and pus were collected and processed for fungal culture. Isolated Candida species were identified using conventional and automated identification methods. Antifungal susceptibility testing was performed using the CLSI broth microdilution method for commonly used antifungal agents, including fluconazole, voriconazole, amphotericin B, and caspofungin. Results: A total of 210 Candida isolates were obtained. Candida albicans accounted for 45% of isolates, while non-albicans Candida species constituted 55%, with Candida tropicalis (22%), Candida glabrata (15%), Candida parapsilosis (10%), and Candida krusei (8%) being predominant. Antifungal susceptibility revealed 18% resistance to fluconazole, primarily among non-albicans species. Voriconazole and amphotericin B exhibited high susceptibility rates across all species, while emerging resistance to caspofungin was observed in 6% of isolates. Conclusion: The increasing prevalence of non-albicans Candida species with variable antifungal resistance patterns underscores the need for routine species identification and susceptibility testing to guide effective antifungal therapy and improve patient outcomes. Keywords: Candida species, antifungal susceptibility, non-albicans Candida, fluconazole resistance, tertiary care hospital, candidiasis.