Current Issue

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.

Background: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and its accurate diagnosis is crucial for effective management. Objective: This study aims to evaluate the semiquantitative expression of CK19 in different thyroid lesions, including PTC, the follicular variant of PTC (FVPTC), follicular adenoma, and multinodular goiter (MNG), and to assess its diagnostic accuracy. Materials and Methods: This cross-sectional study was conducted at tertiary care hospital from June 2020 to June 2023. The sample size for this study comprised 50 thyroid cases. Tissue samples were collected from patients who underwent thyroid lobectomy or total thyroidectomy. The samples were then processed and fixed in formalin, followed by paraffin embedding. Serial tissue sections were prepared for IHC staining. Results: The study revealed that CK19 expression was strongly positive in 80% of usual-type PTC cases (moderate to strong expression). In the FVPTC group, CK19 was moderately expressed in 75% of cases. The follicular adenoma and MNG groups showed minimal to no CK19 expression, with 66.7% and 77.3% of cases, respectively, showing no CK19 staining. The sensitivity of CK19 in diagnosing PTC was 84%, with a specificity of 91%. The positive predictive value (PPV) was 82%, and the negative predictive value (NPV) was 89%. Conclusion: It is concluded that CK19 is a highly sensitive and specific marker for diagnosing papillary thyroid carcinoma, particularly in distinguishing it from benign thyroid lesions such as follicular adenoma and multinodular goiter. The semiquantitative assessment of CK19 expression demonstrated strong, diffuse positivity in usual-type PTC and moderate expression in FVPTC, making CK19 a valuable diagnostic tool. Keywords: Carcinoma, Patients, PTC, FNAC, Metastasis, Diagnosis.

Background: Acute abdomen is a medical emergency with diverse etiologies requiring rapid diagnosis for timely intervention. Imaging plays a pivotal role, with ultrasonography (USG) and plain abdominal radiography (X-ray) being the most accessible first-line modalities in emergency settings. The objective is to evaluate and compare the diagnostic efficacy of ultrasonography and plain radiography in identifying the underlying causes of acute abdomen and to correlate imaging findings with clinical and surgical outcomes. Materials and Methods: A hospital-based cross-sectional study was conducted over one year, including 200 patients aged 18–85 years presenting with features of acute abdomen. All patients underwent USG and plain radiography. Imaging findings were recorded and correlated with final diagnoses. Data were analyzed using SPSS version 23.0, with p < 0.05 considered statistically significant. Results: USG demonstrated high diagnostic accuracy in detecting cholelithiasis (99.9%), appendicitis (90%), pancreatitis (92.8%), and abscesses (99.9%). X-ray was more effective in bowel obstruction (99.9%) and radiopaque calculi (99.9%). Both modalities showed complementary diagnostic value. Conclusion: Ultrasonography and plain radiography serve as valuable complementary tools in evaluating acute abdomen. Integrating both enhances diagnostic precision and supports timely management in emergency care. Keywords: Acute abdomen; Ultrasonography; Radiography; Diagnostic imaging; Abdominal emergencies.

Background: Otomycosis is fungal infection of external ear and middle ear, commonly seen in tropical and subtropical regions. It is common condition encountered in ENT practice. Objective: To study mode of presentation, predisposing factors and types of fungi causing otomycosis. Materials and Methods: This observational study was included 166 patients (90 females and 76 males), 18-60 years of age group who were clinically diagnosed patients of otomycosis, and was carried out in Tertiary Care Hospital & Medical College of India over period of six months from July to December. A detailed history was taken including symptoms and various predisposing factors. Two swab samples were taken from affected ear and were sent to microbiology for identification of fungi causing otomycosis. After that patients were treated by ear cleaning and given antifungal drops/tablets according to presentation. Results: Our study showed maximum patients were of 21-40 years of age (77.71%), female preponderance (54.22%) and unilateral ear involvement (96.98%). Itching (83.13%) was the most common presentation in present study. Most common pre-disposing factor was self-cleaning by unsterile object (83.53%). Aspergillus Niger (79.08%) was found to be the commonest isolated fungus causing otomycosis. Conclusion: Present study highlights the commonest isolation of Aspergillus species in cases of clinically diagnosed otomycosis with common risk factor like self-cleaning to get relief from ear itching. Keywords: Otomycosis, Aspergillus, Candida.

Background: Child malnutrition is a major public health issue worldwide. An estimated 144 million children under age 5 are stunted, 47 million are wasted, and 38.3 million are overweight or obese. Around 45% of deaths among children under 5 years of age are linked to undernutrition. Malnutrition throughout the first five years of life cannot just have a poor effect on a child's physical and mental growth, but can also result in death. While malnutrition is a multifaceted issue, improper feeding habits account for more than two-thirds of cases globally. The present study is an attempt to identify the barriers and facilitators to optimal practices faced by the parents / primary caregivers of these children in the urban slum areas of Delhi. The objective is to study the barriers and enabling factors associated with IYCF practices among children aged 6 – 23 months. Materials and Methods: A community-based cross-sectional study was conducted among 400 children aged 6-23 months residing in the field practice areas of the medical college using simple random sampling. Data was obtained using a semi-structured questionnaire through the researcher-administered interview to parents/caregivers of study participants using good clinical and ethical practices. Data obtained was thus compiled using MS Excel and analysed using SPSS version 26.0. Results: Advice of healthcare workers and family members, as well as prior knowledge of the benefits of good breastfeeding and complementary feeding practices, were the major enablers for appropriate IYCF practices. whereas existing myths, ill-advice given by family members and traditional practices were the barriers identified under study. The study emphasises the pivotal role of healthcare workers. Conclusion: Traditional myths and practices should be addressed to combat inappropriate feeding practices, not just with parents / primary caregivers but also with other members of the family. This can be achieved by community health education programs, as well as one-on-one counselling by local ASHAs, ANMs, AWWs and skilled birth attendants. Keywords: Infant and Young Child Feeding Practices, Enablers and Barriers, Urban Slums.

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Early detection and risk stratification are crucial for improving patient outcomes. Among the various biomarkers under investigation, Red Cell Distribution Width (RDW), which measures the variation in red blood cell size, has emerged as a potential indicator for the severity of CAD. This study aimed to explore the relationship between RDW levels and CAD severity, hypothesizing that elevated RDW values correlate with more advanced stages of CAD. Materials and Methods: This prospective observational study was conducted at Government Theni Medical College over 18 months, enrolling 100 patients diagnosed with acute coronary syndrome (ACS) and other CAD-related conditions. Data were collected using clinical history, examination, and laboratory tests, including complete blood count (CBC) with RDW measurements. Statistical analysis was performed using SPSS software, employing the Chi-square test, Spearman’s rank correlation, and Karl Pearson correlation methods. Results: The study cohort had a mean age of 56.04 years, with 65% male patients. RDW scores were significantly higher in patients with STEMI compared to those with Non-STEMI or Unstable Angina (p < 0.001). RDW was also strongly associated with systolic and diastolic blood pressures (p < 0.001). Patients with greater RDW scores exhibited higher blood pressure levels and more severe left ventricular dysfunction (LVEF). A significant correlation was found between RDW scores and the severity of left ventricular dysfunction, with higher RDW values associated with poorer LVEF (p < 0.001). Discussion: RDW levels correlate with the severity of CAD, particularly in patients with STEMI. The findings suggest that RDW could serve as a simple, inexpensive marker to assess CAD severity, particularly when combined with other clinical indicators like LVEF and blood pressure. Conclusion: Elevated RDW levels are significantly associated with more severe forms of coronary artery disease, including STEMI, higher blood pressure, and worse left ventricular function. RDW may be a useful adjunctive biomarker for assessing the severity of CAD, providing valuable prognostic information for clinical decision-making. Keywords: Coronary Artery Disease, Red Cell Distribution Width, Acute Coronary Syndrome, Prognostic Biomarker, Coronary Angiography.

Background: Suicide is a major global health issue, strongly linked to psychiatric disorders. Both common mental disorders (CMD) and severe mental illness (SMI) significantly increase suicide risk. Early detection of high-risk individuals is critical for prevention. Aim: To assess and compare the prevalence of suicidal ideation and attempts among individuals with CMD and SMI, and identify associated sociodemographic and clinical factors. Materials and Methods: A cross-sectional study was conducted on 80 adults with CMD (n = 40) or SMI (n = 40). Depression and anxiety severity were assessed using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. Obsessive-compulsive symptoms were measured using the Yale-Brown Obsessive Compulsive Scale. General psychiatric symptoms were evaluated with the Brief Psychiatric Rating Scale. Suicidal ideation and intent were assessed using Beck’s Suicidal Ideation Scale and Suicide Intent Scale. Data were analysed using SPSS; p < 0.05 was considered significant. Results: Suicidal ideation was present in 38.6% of patients with CMD and 36.1% of patients with SMI. Suicide attempts were more frequent in the CMD (18.2%) than in the SMI (5.6%) group, although this difference was not significant. Major depressive disorder was most commonly associated with both ideation (60%) and suicide attempts (30%). Females exhibited higher suicidal ideation (55.6%), whereas males had more attempts (66.7%). Suicidal behaviour was more common among younger individuals and those from lower-middle socioeconomic backgrounds. Conclusion: Suicidal ideation and attempts were common and comparable in CMD and SMI. Risk factors such as age, gender, and family history underline the importance of routine suicide risk screening in psychiatric care. Keywords: Suicide, Suicidal Ideation, Suicide Attempt, Common Mental Disorders, Severe Mental Illness, Depression, Risk Factors.

Background: There is an increase in incidence of knee osteoarthritis among middle-aged individuals, leading to pain and functional limitation. Medial Open Wedge High Tibial Osteotomy (MOWHTO) is a joint-preserving surgical procedure designed to realign the mechanical axis and offload the diseased compartment. The usage Tomofix plate offers better biomechanical stability and prevents the loss of correction thus allowing early mobilization and reliable healing. This study aims to evaluate the functional and radiological outcomes of MOWHTO using the Tomofix plate. Materials and Methods: This prospective interventional study was conducted at NRI Institute of Medical Sciences, Visakhapatnam, over a period of 24 months. 20 patients with symptomatic medial compartmental OA were selected based on strict inclusion criteria. Functional outcomes were assessed using the Knee Society Score, Visual Analogue Scale and Range of Motion. Radiological outcomes were evaluated via Hip-Knee-Ankle (HKA) angle measurements pre- and post-operatively. Results: The mean age of population in this study is 54.45 with 60% females and 40% males. The mean BMI is 25.17. The mean HKA angle improved significantly from 170.5° preoperatively to 184.2° postoperatively indicating successful correction of varus deformity. VAS scores decreased from a mean of 6.8 to 2.6. The KSS score improved from 54.1 to 90.6 and Functional KSS scores also showed significant improvement from 50.2 to 85.5. The overall complication rate is 10%. Conclusion: MOWHTO using the Tomofix plate is a safe and effective procedure for selected patients with medial compartmental OA. It significantly improves pain, alignment, and functional outcomes with minimal complications, reinforcing its role as a viable alternative to knee arthroplasty in active, physiologically young individuals. Keywords: High Tibial Osteotomy, Tomofix Plate, Osteoarthritis, KSS score, VAS score.

Background: Brachial plexus blockade is the cornerstone of regional anaesthesia practice of most anaesthesiologists. The supraclavicular approach is one of several techniques used to accomplish anaesthesia of the brachial plexus and is performed at the level of the brachial plexus trunks where almost entire sensory, motor and sympathetic nerve supply of the upper extremity is carried. Consequently, typical features of this block include its rapid onset, predictability and density. the objective is to compare dexmedetomidine and clonidine when added to a local anaesthetic solution for Supraclavicular brachial plexus block for upper limb orthopaedic surgeries with respect to Onset of sensory blockade, Onset of motor blockade, Duration of sensory blockade and Duration of motor blockade Materials and Methods: The present Randomized Controlled Trial was carried out at Anaesthesia department involving patients to be posted for upper extremity orthopaedic surgeries in RK Damani Medical College SRIMS Chhatrapati Sambhajinagar, Maharashtra during the study period from January 2024 to December 2024. Results: Proportion of females in Group C were 40% as compared with 22.2% in Group D. Proportion of males in Group C were 60% as compared with 77.8% in Group D. Sensory blockade onset was earlier in Group D as compared with Group C. Motor blockade onset was earlier in Group D as compared with Group C. Duration of sensory blockade was prolonged in Group D as compared with Group C. Duration of motor blockade was prolonged in Group D as compared with Group C. Conclusion: Sensory and motor blockade onset was earlier in Group D as compared with Group C. Duration of sensory and motor blockade was prolonged in Group D as compared with Group C. Keywords: Dexmedetomidine, clonidine, supraclavicular brachial plexus block for upper limb orthopaedic surgeries.

Background: The histogenesis and progression of cervical carcinoma is well documented. It is possible to prevent the development of invasive carcinoma by identifying and treating pre invasive lesions. This study was a prospective study conducted from 01 July 2014 to 01 July 2016. The objectives of the study were to evaluate and interpret the cases of precancerous and cancerous lesions according to The 2001 Bethesda System and to correlate cytology diagnosis with histopathology diagnosis. Materials and Methods: Pap Smears were received along with their corresponding cervical biopsies or hysterectomy specimens in the Department of Pathology, Raja Rajeswari Medical College and Hospital, Bangalore. The Pap smears were stained with Papanicolaou stain and the corresponding biopsies or hysterectomy sections were stained with H & E stain and examined for microscopic details. Results: The cytological evaluation of 200 pap smears was done and 61.5% of lesions were reported as Negative for intraepithelial lesion or malignancy, 15% as ASCUS, 11% as LSIL, 5.5% each as HSIL and SCC and the remaining 1.5% as positive for malignancy. Majority of the women were from the age group of 41-50 years and the commonest presenting complaint was white discharge per vaginum. Of 200 specimens received for histopathology, 137 (68.5%) were reported as Benign, 37 (18.5%) as Premalignant and 26 (13%) as Malignant. Amongst the 37(18.5%) premalignant lesions encountered on histopathology, 11% cases were reported as koilocytic atypia, 43% cases as CIN 1, 27% cases as CIN 2, 16% cases as CIN 3 and 3% cases as CIS. The total number of malignant lesions were 26 (13%) in number. Out of these, 92% were reported as Squamous cell carcinoma and 4% cases each of microinvasive SCC and Adenocarcinoma. Of these 24 cases of SCC, 58% cases were moderately differentiated SCC, 33% were well differentiated SCC and 9% cases were diagnosed as poorly differentiated SCC. Conclusion: The regular screening of population by Pap smear and reporting as per The 2001 Bethesda System is a cost-effective method for early detection of premalignant and malignant cervical lesions. The procedure is simple, inexpensive and can be performed in the outpatient department which is useful in a country like ours. It also has an important role in the diagnosis of inflammatory lesions including the identification of causative organism and atrophic changes and helps in the definitive management of patients. All lesions on Pap smears should be followed by repeat Pap smear examination and cervical biopsies hysterectomy which will improve the diagnostic accuracy and help in staging of malignant lesions. Keywords: The 2001 Bethesda System, Papanicolaou stain, cervical biopsy.

Background: Irrational drug prescriptions frequently occur in clinical practice, primarily due to insufficient knowledge regarding medication prescribing. Developing nations possess constrained financial resources for healthcare and pharmaceuticals, making it imperative to prescribe medications judiciously. The data on WHO core drug use indicators (prescribing indicators, patient care indicators, and facility care indicators) was collected prospectively through prescriptions, registration books, patient interviews, and patient observations, all conducted with prior consent. This study aimed to evaluate drug utilisation patterns in paediatrics by assessing prescribing indicators, patient care indicators, facility indicators, and complementary indicators. Materials and Methods: A total of 149 prescriptions for paediatric patients aged from newborn to 12 years were collected. This study aims to assess prescription patterns based on the key drug use indicators set by the World Health Organisation (WHO). Results: The examination of prescribing indicators indicated an average of three medications per prescription encounter. The proportion of medications prescribed from the Essential Drug List reached a full 100%. The percentage of medications prescribed using their generic names was documented at 97.98%. Antibiotics comprised a notable category of prescribed medications, accounting for 19.46%, followed by vaccines at 16.77%. Conclusion: The imperative to fortify logical prescribing practices and elevate awareness among physicians and medical students. This initiative should involve comprehensive training programmes that highlight the importance of evidence-based medicine and the potential risks of irrational prescribing. Additionally, continuous monitoring and evaluation of prescribing patterns will be essential to ensure compliance with the newly established standards and to promote a culture of responsible medication use. Keywords: Drug Utilisation, World health organization, Prescription, Antibiotics.

Background: The aim is to study the accuracy of MDCT in the diagnosis of paediatric abdominal tumours and its effectiveness in differentiating benign from malignant tumours. Materials and Methods: Pediatric Patients referred to the radiology department with USG findings suggestive of abdominal tumors and others clinically indicated. 70 Patients Both genders of Pediatric age group (0-18 years) who came to the Radiodiagnosis in the period of 24 months with relevant history and clinical examination were subjected to this study. Results: In this study, out of 70 patients, most common pediatric abdominal tumour is Wilms tumour (n=17), followed by hepatoblastoma (n=13) and germ cell tumours (n=10). Equal number of Neuroblastoma and Lymphoma (n=8) is seen. In this study, sex distribution of 60% males and 40% females noted. Among NB cases, extending cross midline, 50% are adrenal in origin, 75% showed vascular encasement, 25% patients had distant metastasis. Coarse, amorphous calcifications are common in Neuroblastoma. All Teratoma cases are heterogenous with mixed solid cystic areas with calcifications and fat. Majority of hepatoblastoma cases are seen in males (84.6%). Mass and pain abdomen were common symptom/sign of hepatoblastoma after abdominal distension. 38% of hepatoblastoma showed associated tumour thrombus. 60% of RMS cases are females, most of them presenting with very large mass and had their origin in pelvic structures predominantly (60%) in bladder. Retroperitoneal lymphoma showed low attenuation on plain CT and homogenous enhancement on contrast studies and encasing vascular structures. 10 (14.28%) cases were of germ cell origin with 2 each of sacrococcygeal and retroperitoneal teratoma. Conclusion: Contrast enhanced CT accurately localized site of origin, morphology of tumour relationship with neighbouring structures, vascular encasement or infiltration, tumour characteristics with necrotic areas. Besides CT also being considerably cost effective and widely available, it is preferred preoperative method of evaluating retroperitoneal mass in a child. Keywords: Multidetector Computed Tomography, Ultrasonography, Neuroblastoma, Rhabdomyosarcoma.

Background: Lipohypertrophy (LH) frequently occurs in people with type 2 diabetes mellitus (T2DM) treated with insulin, which may negatively affect insulin absorption and glycemic control. This study aimed to identify the prevalence of LH and its associated risk factors among patients with T2DM who inject insulin. Materials and Methods: This cross-sectional observational study included a sample of 40 patients with T2DM who were undergoing insulin therapy. Demographic and clinical parameters, methods of insulin administration, and glycemic control data were obtained. LH was evaluated through physical assessment. Relevant statistical tests and multivariate logistic regression analyses were used to analyze the associations. Results: LH was prevalent in 60. LH was found to be closely related to increased duration of diabetes (p<0.001), insulin therapy for > 5 years (OR=6.85, p=0.001), needle reuse > 5 times (OR=5.92, p=0.003), irregular rotation of sites (OR=4.37, p=0.01), and longer needles (OR=3.95, p=0.02). HbA1c (9.4+1.5% vs 8.1+1.2%, p=0.003), insulin doses, and hypoglycemic episodes were also increased in Conclusion: LH is common in T2DM patients who inject insulin and have poor injection technique, along with poor glycemic outcomes. Regular education on insulin administration to lower LH levels and achieve better metabolic control should be conducted. Keywords: Lipohypertrophy, Prevalence, Type 2 Diabetes Mellitus, Insulin injection.

Background: Aim: To study the clinical, etiological and radiological profile of Cerebral Venous Thrombosis in male patients. Materials and Methods: This cross-sectional study was carried out in the Neurology department. study subjects were adult male patients who were admitted with acute headache and other neurological features with CT/ MRI/ MRV (brain) findings of Cerebral Venous Thrombosis Results: The majority of patients were of 3rd and 4th decade, with a mean age of 35.5 + 11.75 years. Headache was the most common symptom, reported by all patients, followed by seizures (74%), vomiting (62%), and blurred vision (32%). Focal neurological deficits (45%) and papilledema (32%) were the most frequently observed clinical signs. Elevated serum homocysteine levels were found in 59% of patients, of which 52% were alcoholics. A statistically significant link was found between alcoholism and elevated serum homocysteine. Additional risk factors for CVT in males include infections (10%), connective tissue disorders (6%), protein C deficiency (6%), protein S deficiency (5%), dehydration due to diarrhea (3%), anemia (3%), antithrombin-III deficiency (1%), and antiphospholipid antibody syndrome (1%). The cause was unknown in 6% of cases. The superior sagittal sinus (SSS) was the most frequently affected sinus (69%), in males followed by the transverse sinus (45%), either individually or in combination. Conclusion: There is a need to increase the awareness among people regarding the effects of alcohol and necessary steps to reduce the consumption of alcohol. Keywords: Superior sagittal sinus (SSS), Straight sinus(SS), Magnetic Resonance Venography (MRV).

Background: Chronic liver disease (CLD) significantly contributes to morbidity. In the case of CLD, high levels of plasma glucose and HbA1c are linked to both severe disease and poor prognosis, independently of each other. Materials and Methods: This cross-sectional and observational study, conducted in the Department of General Medicine at World College of Medical Sciences Research and Hospital in Jhajjar, was based in a teaching hospital. The study included sixty known diabetic patients, both with and without CLD, who met the criteria for chronic hepatitis C. Results: The current study involved 60 participants, who were split into groups I and II. Group I consisted of 30 participants with chronic hepatitis C and diabetes, with a mean age of 58.64±12.24 years, while Group II included 30 participants without chronic hepatitis C but with diabetes, having a mean age of 52.32±10.16 years. Low levels of fasting blood glucose were seen in group I than group II (144.29±26.24 mg/dl vs. 202.12±28.67 mg/dl p<0.02). Low levels of fasting blood glucose were seen in group I than group II (144.29±26.24 mg/dl vs. 202.12±28.67 mg/dl p<0.04).Group I also exhibited lower HbA1c levels compared to group II (6.62±1.34% vs. 8.67±2.64%, p<0.04). Group I had a significantly higher serum ALT level compared to group II (78.21±21.36 IU/L vs. 36.54±12.34 IU/L, p<0.05). Group I exhibited a significantly elevated serum AST level in comparison to group II (62.58±18.36 IU/L vs. 28.32±12.52 IU/L, p<0.04). In group I, HbA1c levels showed a significant negative correlation with ALT (r=0.42, p<0.02), whereas in group II, this correlation was not statistically significant (r=0.12, p=0.52). Conclusion: These findings suggest that HbA1c levels are significantly lower in diabetic patients with chronic hepatitis C compared to those without chronic liver disease. As a result, HbA1c cannot be trusted as an accurate predictor for long-term glycemic monitoring in diabetic patients with chronic liver disease. Keywords: Chronic liver disease, hepatitis C, FBS, HbA1c, AST & Diabetes mellitus.

Background: Subarachnoid and epidural blocks are widely used regional anesthesia techniques for lower abdominal and limb surgeries. Epidural anesthesia offers effective surgical anesthesia, extended duration, and prolonged postoperative analgesia with fewer hemodynamic changes. Ropivacaine, a newer amide local anesthetic, has lower cardiovascular toxicity than Bupivacaine but causes less motor block. Dexmedetomidine, a highly selective α2 agonist, provides sedation, stable hemodynamics, and prolonged analgesia. This study compares 0.75% Ropivacaine with and without Dexmedetomidine in epidural anesthesia for enhanced postoperative pain control. Materials and Methods: One hundred patients, scheduled for various elective lower abdominal and lower limb surgical procedures belonging to ASA class I and II were included in the study. The patients were normotensive with ages varying from 18 to 65 years. The study population was randomly divided into two groups with 50 patients in each group Group R - 15ml of 0.75%Ropivacaine Group RD - 15ml of 0.75% Ropivacaine + 0.6µg/kg of Dexmedetomidine. Onset and duration of sensory blockade, Onset and duration of motor blockade, Haemodynamic changes, Maximum dermatomal level of analgesia, Intensity of motor blockade, and any adverse effects. Results: The dexmedetomidine group had a rapid onset of action (p<0.05), prolonged duration of sensory and motor block (p<0.05), better sedation score and postoperative analgesia (p<0.05), and more intense motor block (p<0.05). There was no difference in the maximal dermatomal level of analgesia, incidence of hypotension, and bradycardia (p>0.05). The occurrence of side effects (tremors, nausea, and SpO2<90%) was low and similar between groups(p>0.05). Conclusion: There is a clear synergism between Dexmedetomidine and Ropivacaine compared with plain Ropivacaine in epidural anesthesia without increased morbidity. Keywords: Dexmedetomidine, Epidural Anaesthesia, Ropivacaine, Lower Abdominal Surgeries.

Antimicrobial resistance (AMR) is a looming global threat that compromises the efficacy of life-saving drugs in both human and veterinary medicine. The exaggerated misuse of antibiotics in humans, animals, as well as agriculture have led to the evolution and spread of multidrug-resistant organisms. This paper explores AMR from a One Health perspective, emphasizing the interconnectedness of human, animal, and environmental health. It examines drivers of resistance, surveillance challenges, and policy gaps, while also highlighting potential strategies for mitigation. Strengthening cross-sectoral collaboration and data sharing, particularly in low- and middle-income countries, is essential to address AMR sustainably. Keywords: Antimicrobial Resistance; Human-Animal-Environment; Antibiotic stewardship; Cross-sectoral Collaboration; AMR Policy Gaps; Multidrug Resistance; AMR Surveillance; Public Health; Global Health

Background: Benign Paroxysmal Positional Vertigo (BPPV) is characterized by brief episodes of vertigo, nausea and/or positional nystagmus upon head movements, is produced by the inadequate presence of statocone particles coming from the utriculus macula floating in the endolymph of the semi-circular canal or attached to their cupule. BPPV is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. Most patients complain of a loss of equilibrium and unstable gait during and between the vertigo attacks. Materials and Methods: This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance in subjects with BPPV by using DHI and modified Clinical Test of Sensory Integration and Balance (mCTSIB). A total of 40 patients with BPPV were included prospectively in the study. All patients were asked to fill out the questionnaire including both DHI and mCTSIB was measured. Results: There were no significant differences in age; study results showed significantly higher DHI score and abnormal mCTSIB. DHI score and the number of abnormal mCTSIB showed a statistically significant correlation. Conclusion: Better static and dynamic balance represents better performance in Physical, Functional Tasks. Study concluded that Better functional independence and community integration reduces stress and anxiety in BPPV patients irrespective of their stage of recovery. Keywords: Benign Paroxysmal Positional Vertigo; Dizziness; Posture Balance; Surveys, Questionnaires.

Background: Low back pain (LBP) is a widespread complaint in outpatient clinics globally. As a crucial component of the kinetic chain, LBP affects the biological infrastructure that supports movement. This study aimed to investigate the correlation between LBP and lumbosacral angle in overweight patients. Materials and Methods: This study was conducted on 200 patients with LBP at the Department of Orthopaedics, Jawaharlal Nehru Medical College, and Acharya Vinoba Bhave Rural Hospital. Patients were divided into test and control groups. Anthropometric measurements, including height and weight, were taken, and BMI was calculated. Self-reported pain was assessed using a visual analog scale (VAS). Radiographs of the lumbosacral spine were evaluated for angle measurements. Results: The mean age of the test group was 46.48 years, and the control group was 43.52 years. Average VAS scores were significantly higher in the test group (p=0.0375), indicating more severe pain. Lumbosacral angles were also significantly higher in the test group. Notably, females in both groups had significantly higher lumbosacral angles (p<0.001). Conclusion: This study demonstrates that overweight and obesity are potential risk factors for LBP, as they cause biomechanical alterations in the lumbosacral spine. Maintaining a healthy weight is crucial to prevent LBP. The findings of this study highlight the importance of weight management in reducing the risk of LBP. Key Words: Low back pain, Overweight.

Background: Chronic rhinosinusitis is a complex disease that has previously been used to describe conditions ranging from unilateral single sinus disease, odontogenic sinusitis, fungal sinusitis to widespread airway inflammation. The present study was conducted to evaluate the role of concha bullosa in chronic rhinosinusitis. Materials and Methods: The prospective cross-sectional study was carried out in the Department of Otorhinolaryngology, Parul Sevashram Hospital, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat (India) from April 2024 to March 2025 among 120 patients who were clinically and radiologically diagnosed as having chronic rhinosinusitis. Patients were evaluated with the help of CT scan paranasal sinuses and by nasal endoscopy. The collected data were evaluated and analysed statistically. Results: Maximum patients (25%) with chronic rhinosinusitis and with concha bullosa belong to age group 21-30years followed by 11-20 years (15%). Maximum patients (15%) with chronic rhinosinusitis and without concha bullosa belong to age group 21-30years followed by 11-20years (12.5%). Out of 120 patients 72.5% were male and 27.5% were female. 45% male patients were with chronic rhinosinusitis and with concha bullosa and 15% female patients were with chronic rhinosinusitis and with concha bullosa. Conclusion: The present study concluded that 60% patients were with chronic rhinosinusitis and with concha bullosa. Keywords: Chronic Rhinosinusitis, Concha Bullosa, Airway Inflammation

Background: A study of primary emergency caesarean delivery between booked and unbooked cases at Tertiary Center. Materials and Methods: Prospective observational study in subjects admitted in the given study done for a period of 18 months. Booked and unbooked antenatal cases admitted and who underwent emergency caesarean delivery, Term gestation (early and late term) and singleton pregnancy are enrolled in study. Results: Total 2336 patients with booked cases in 1408 and unbooked 928 cases are studied. Emergency caesarean sections were more frequent among booked mothers as most of the cases are of high risk category landing in Caesarean section. most of the patients belonging to Socio-economic status of II and III . Severity of the SE Status is associated with the booking status of mothers. Teenage pregnancy is more in unbooked group. Hypotension and PPH were the most common intraoperative complications among both booked and unbooked mothers. The proportion of cases indicates, albeit relatively small, required NICU admission, with a higher percentage observed in the unbooked group compared to the booked group. Maternal outcomes between booked and unbooked cases, with booked cases with much lower incidence of maternal mortality. Conclusion: Booked antenatal patients have better maternal outcome and perinatal outcome in terms of mortality when compared to Unbooked patients. Keywords: National Rural Health Mission(NRHM), Haemolysis , Elevated Liver Enzymes, Low Platelets (HELLP), unbooked cases.

Background: The aim is to assess safety and efficacy of laparoscopic to open varicocelectomy in terms of duration of surgery, hospital stay, postoperative analgesia requirement, postoperative recovery and complications. Materials and Methods: Single centre, prospective study was conducted on 50 Patients admitted in the Department of General Surgery with varicocele requiring surgical intervention, for a period of 2 years in All patients with clinical or radiological evidence of varicocele, Patients with Primary varicocele. cases were randomly grouped in to two groups as Group A patients had Open Varicocelectomy and Group B had Laparoscopic Varicocelectomy. Results: In our study we noted, in laparoscopic varicocelectomy group mean operative time was 58min and in open varicocelectomy group mean operative time was 93.3min. In both the groups, no vascular or intestinal complications are noted. Conversion from laparoscopic to open approach also didn’t occur either. In our study of 50 patients, 3 patients from group A and 1 patient from group B developed hydrocele. Scrotal oedema was noted in 4 patients from group A and 2 patients from group B. Wound infection was noted in 2 patients from group A and none developed any wound infection group B. 22 patients from group B stayed for 2 days and 7 patients for 3 days. In group A zero patients for 2 days, 12 patients stayed for 3 days and 13 patients stayed for 4 days. We have analysed the mean sperm count and mean % motility of sperm in preoperative period and 3 months after the surgery. We have noted improvement in sperm count and motility in post operative period. Duration to return to normal activity after surgery was 6-7 days in group A and 3-4 days in group B. Conclusion: Laparoscopic varicocelectomy is safe and effective procedure when compared to open varicocelectomy with significant reduction in operative time, minimal post-operative complications and decreased hospital stay, increasing the patient satisfaction and comfort towards the procedure. Keywords: Laparoscopic varicocelectomy, open varicocelectomy, wound infection, post-operative complications.

Background: Intensive care plays a central role in the management of critically ill patients, especially those requiring advanced airway, respiratory, and hemodynamic support. Hence; the present study was conducted to analyze pattern of patients admitted to intensive care. Materials and Methods: A total of 200 patients admitted during the study period were included based on specific eligibility criteria. Data collection was facilitated using a structured questionnaire designed to capture comprehensive information, including socio-demographic details, reasons for ICU admission, sources of referral, and clinical outcomes. Patient information was systematically gathered through chart reviews and documented medical records. The collected data were thoroughly cleaned, coded, and entered into the Statistical Package for the Social Sciences (SPSS) software for analysis. Results: A total of 200 patients were evaluated. 66 percent of the patients belonged to the age group of more than 50 years. 71 percent of the patients were males while 59 percent were of rural residence. Source of admission to ICU was medical ward in 50.5 percent followed by emergency department (32 percent), surgical ward (16.5 percent) and gynaecology ward (1 percent). Myocardial infarction was the most common diagnosis followed by Congestive heart failure and Acute respiratory distress syndrome. Other specific diagnosis included Septic shock, Diabetic ketoacidosis, stroke and pneumonia. Conclusion: Assessing the pattern of patients admitted to intensive care units (ICUs) is essential for optimizing resource allocation, guiding clinical decision-making, and improving patient outcomes. Ultimately, such assessments contribute to reducing ICU mortality and enhancing the overall efficiency and responsiveness of healthcare systems. Key words: Intensive Care Unit, Critically Ill, Myocardial Infarction.

Background: In medical education, particularly in subjects such as biochemistry, students face challenges in managing vast amounts of content. Selecting effective self-directed learning strategies is crucial for enhancing knowledge retention. Among the various techniques, mind mapping and conventional note-making are widely used, but their comparative effectiveness remains underexplored. Objectives: Primary Objective: To compare the immediate and one-month delayed post-test scores following mind mapping versus conventional note-making for learning Biochemistry among Phase I MBBS students. Secondary Objective: To determine student perceptions regarding the effectiveness of mind mapping and conventional note-making as learning strategies. Materials and Methods: A comparative interventional study was conducted among 110 Phase I MBBS students at Government Medical College, Manjeri. Students were divided into two groups: one group used mind mapping, and the other used conventional note-making to study selected Biochemistry topics. A pre-test, an immediate post-test, and a one-month delayed retention test (MCQ-based) were conducted. Students’ perceptions were assessed using a validated questionnaire with a 10-point Likert scale. Data were analyzed using independent t-tests and descriptive statistics. Results: Both learning strategies significantly improved post-test scores compared to pre-test scores (p < 0.0001). However, there was no statistically significant difference in the immediate or delayed post-test scores between the mind-mapping and conventional note-making groups (p > 0.05). Notably, a higher proportion of students perceived mind mapping as more effective in clarifying objectives, enhancing conceptual understanding, and increasing engagement. Conclusion: Mind mapping and conventional note-making are equally effective in improving learning outcomes and knowledge retention in Biochemistry. However, mind mapping is more positively perceived by students for its clarity, engagement, and support in conceptual understanding. Integrating mind mapping as a supplementary tool in medical education may enhance learner motivation and comprehension. Keywords: Mind Mapping, Note-Making, Biochemistry Education, Medical Students, Self-Directed Learning, Knowledge Retention, Learning Strategies, Competency-Based Medical Education (CBME), Active Learning, Undergraduate Medical Education.

Background: Elderly patients have higher incidence of renal diseases; renal biopsy plays vital role in the diagnosis. The aim is to study the clinical profile and the spectrum of histopathological findings in the elderly patients undergoing renal biopsy. Materials and Methods: This retrospective study includes all patients (age ≥60 years) undergoing native renal biopsies from January 2022 to June 2023. The clinical profile, laboratory parameters & renal biopsy findings were recorded from the Departmental Data. Results: Out of 763 renal biopsies, 72 (9.43%) were performed on the elderly patients. Mean age was 65.8 ± 4.5 years, Male: Female Ratio was 1.5:1. The commonest indication for biopsy was nephrotic syndrome (NS) (49%) followed by rapidly progressive renal failure (RPRF) (25%) and acute kidney injury (AKI) (14%). On histopathology, 54% patients had primary glomerulonephritis (GN), 22% secondary GN, 17% tubulo-interstitial and 7% had vascular disease. Membranous nephropathy (MN) (25.4%) was the commonest findings in primary GN followed by Focal segmental glomerulosclerosis (10.9%), IgA nephropathy (10.9%) and Membranoproliferative glomerulonephritis (9.09%). Amyloidosis (12.7%), Anti GBM disease (9.09%), Diabetic Nephropathy (5.4%) followed by Lupus nephritis (1.81%) were the commonest secondary GN. MN and Crescentic GN were most common findings of NS and RPRF respectively. Conclusion: The commonest indication for renal biopsy in elderly was nephrotic syndrome. Primary glomerular disease was more common than secondary glomerular disease. Membranous nephropathy was the commonest histopathological diagnosis in glomerular diseases. Keywords: Elderly, Nephrotic Syndrome, Renal Biopsy.

Background: Isolated supraspinatus tendon tears are a common cause of shoulder dysfunction and pain, particularly in middle-aged and active populations. While arthroscopic techniques are widely used, the mini-open repair offers direct tendon visualization with favorable outcomes, especially in resource-constrained settings. This study aimed to assess the functional outcomes and recovery patterns following mini-open repair of isolated supraspinatus tendon tears over a 12-month postoperative period. Materials and Methods: This prospective interventional study included 94 patients with MRI-confirmed isolated supraspinatus tears undergoing mini-open repair at a RAMA MEDICAL COLLEGE HAPUR tertiary care center in India. Patients were evaluated preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 12 months using the Visual Analog Scale (VAS), Constant-Murley Score (CMS), University of California Los Angeles (UCLA) Score, and range of motion (ROM) parameters. Functional grading, time to return to work, complications, and patient satisfaction were also recorded. Results: The mean age of patients was 52.6 ± 8.3 years, with 61.7% being male and 70.2% having dominant-arm involvement. The mean CMS improved significantly from 41.5 ± 6.9 preoperatively to 88.5 ± 5.7 at 12 months (p < 0.001), and UCLA scores improved from 15.2 ± 3.4 to 32.1 ± 2.3 (p < 0.001). VAS scores decreased from 7.8 ± 1.2 to 1.3 ± 0.6. Range of motion improved markedly, with forward flexion increasing from 92.3° to 158.2°, and internal rotation improving from L5 to T10 level. At 12 months, 93.6% of patients were satisfied or very satisfied; 86.2% returned to pre-injury work levels within a mean of 9.1 ± 2.3 weeks. Complications were minimal, with tendon re-tear occurring in 2.1% of cases. Conclusion: Mini-open repair of isolated supraspinatus tendon tears results in excellent functional outcomes, substantial pain relief, improved shoulder mobility, and high patient satisfaction. It remains a viable and effective option, particularly in Indian healthcare settings with limited arthroscopic resources. Keywords: Supraspinatus tendon tear, Mini-open repair, Shoulder function, Rotator cuff, Constant-Murley Score, Postoperative outcomes.

Background: Adolescent girls are highly vulnerable group that prone for many health related issues. Adolescent pregnancy is one of most common issues that lead to maternal and fetal morbidity and mortality. Aims and Objectives: (a) to study the maternal complications specific to teenage mothers during ante partum, intra partum and postpartum period; (b) to analyse the mode of delivery to know whether caesarean section rate is increased in teenage pregnancy; (c) to study the neonatal outcome in teenage pregnancy; and (d) to analyse the factors contributing to teenage pregnancy. Materials and Methods: a) Study place: Lakhimpur Medical College and Hospital, North Lakhimpur, Assam b) Study period: 01-01-2024 to 31-03-2024 (three months) c) Study design: Hospital record based retrospective cross-sectional study d) Source of data: This is a hospital record based retrospective cross-sectional study. Results: In our study it was found that 47.37% pregnant women are in the age group of 19 years, 97.11% women are primi gravida and 52.97 % women are in 39-40 weeks of gestation. 32.6% women have not done ANC. 87.95% women have delivered babies via normal vaginal delivery and 15.28% women have opted for post partum sterilization. In this study it was observed that fetal complication are there after birth out of which 10.02% IUGR, 19.5% LBW babies, 10.07% prematurity, 9.51% respiratory distress, 11.71% neonatal jaundice, 7.98% sepsis, 23.09% NICU/SNCU admission and 5.43% neonatal death. Regarding maternal outcome of adolescent pregnancy, it was found that 44.14% women are moderate anemic while 16.81% women have hypertensive disorders and 2.5% women have ante partum haemorrhage. Regarding post partum complications of pregnant women, it was found that 3.9% women have post partum haemorrhage, 7.47% having fever, 2.72% having urinary tract infection and 2.55% women have local sepsis. 1.19% women got admitted in ICU. Conclusion: fetal and maternal complications are much more amongst adolescent women. Health education and proper guidance is always necessary to tackle the situation of teenage pregnancy. Keywords: adolescent pregnancy, delivery, Lakhimpur.

Background: Now a days the prevalence of diabetes is beyond the expected values in the developing countries. In India, there are estimated 77 million people aged >18 years are suffering from type 2 diabetes and nearly 25 million are prediabetics. Awareness, knowledge, Screening, prediction of risk and treatment of diabetes is mandatory to reduce the premature deaths due to diabetes and other non-communicable diseases. Objective of this study is to assess the diabetic risk among healthy adults aged >20 years and its associated factors those are residing in rural area of Srikakulam. Materials and Methods: community based cross sectional study was done among adult rural population of Srikakulam district, Andhra Pradesh. House to house survey was done and the participants was selected randomly; risk assessment of diabetes was done by Indian diabetes risk score among adults >20 years of age and not a known diabetic patient. Results: Out of 243, assessment of risk is 58 (23.9%) were high risk, 165 (67.9%) medium risk and 20 (8.2%) were low risk of diabetes. Those who are non-smokers has 46(18.9%) high risk of diabetes than smokers 12(4.9%) with p value (0.01), it is statistically significant. Conclusion: This study was found that, 23.9% was high risk of getting diabetes and many participants were not knowing their health status. Assessment of health status at community one of the important steps to early identification of the chronic diseases, and prevent their complications in advanced age. Keywords: Screening of diabetics, IDRS, Non-communicable diseases, Cross sectional study.

Background: Acute Kidney Injury (AKI) is a critical condition in pediatric intensive care units with significant morbidity and mortality. Early biomarkers for AKI prediction remain limited. This study aimed to evaluate serum bicarbonate, sodium and calculated serum osmolality as markers for predicting early AKI within three days of admission and analyze their correlation with pRIFLE and KDIGO criteria. Materials and Methods: This hospital-based observational study was conducted at Mahatma Gandhi Medical College & Hospital, Jaipur from April 2023 to August 2024. Ninety pediatric patients aged 1-15 years admitted to PICU through emergency room were included. Patients with pre-existing kidney disease were excluded. Serum bicarbonate, calculated serum osmolality, and eGFR were measured at 0, 24, and 48 hours. AKI staging was performed using both pRIFLE and KDIGO criteria. Results: The study included 90 patients with mean age 4.93±3.92 years, predominantly males (68.9%). Mean AKI duration was 5.30±3.49 days with 67.8% recovering within 1-5 days. Serum bicarbonate showed significant correlation with AKI progression, declining from 22.09±3.42 mmol/L at baseline to 17.18±3.11 mmol/L in pRIFLE Failure group at 48 hours (p=0.001). Serum osmolality increased significantly with AKI severity, reaching 402.70±23.62 mOsm/kg in Failure group. Strong positive correlations were observed between bicarbonate and eGFR (r=0.279-0.303, p<0.05) and between osmolality and eGFR (r=0.706-0.750, p<0.001). pRIFLE identified 85.1% patients as Risk category while KDIGO showed more distributed staging (47.8% Stage I, 34.4% Stage II, 17.8% Stage III). Conclusion: Serum bicarbonate and calculated serum osmolality serve as valuable early biomarkers for AKI prediction and staging. Bicarbonate levels correlate inversely with AKI severity while osmolality increases with disease progression. Both biomarkers complement traditional criteria in early AKI detection and risk stratification. Keywords: Acute kidney injury, bicarbonate, serum osmolality, pRIFLE, KDIGO, pediatric intensive care.

Background: The aim is to study efficacy of heat stable oxytocin analogue injection carbetocin in prevention of PPH in comparision to injection oxytocin by an observational study in 300 patients delivering both vaginally and by caesarean section. Materials and Methods: The study was conducted at Deccan College of Medical Sciences (Owaisi Hospital and Research Centre and Princess Esra Hospital). The study was conducted from JULY 2023- DEC 2024(18 MONTHS). It is a prospective study comparing injcarbetocin and inj oxytocin in prevention of PPH.300 woman delivering vaginally and by caesarean section were given injcarbetocin and inj oxytocin alternately after delivery of the baby. PPH is preventable and important cause for maternal morbidity and mortality. Patients were divided into two groups 150 each. Group A received injcarbetocin and group B received inj oxytocin after the delivery of the baby. Results: The dose of injcarbetocin was 1 ml containing 100 microgram carbetocin which was administered by I.M route after the delivery of the baby in vaginal and caesarean deliveries. The dose of inj oxytocin was 10 IU by I.M administration after the delivery of the baby in vaginal and caesarean deliveries. In both the groups the blood loss intrapartum and postpartum was not of much difference. The heat stable carbetocin does not require cold chain for maintenance in contrast to oxytocin which needs cold chain maintainance. Hence its use can be encouraged in developing countries where maintaining cold chain can be challenging. Conclusion: From this study we come to a conclusion that both injcarbetocin and inj oxytocin are equally efficacious in preventing PPH with equal amount of blood loss intra partum and postpartum. Keywords: PPH, Carbetocin, Intrapartum, Oxytocin, Ceaserean Section, Postpartum Haemmorhage.

Background: The uterus is composed of two primary layers: the myometrium and the endometrium. The endometrium undergoes cyclical transformations during the menstrual cycle, influenced by steroid hormones. Uterine leiomyomas, also known as fibroids, are benign tumors found in many women of reproductive age. These tumors are hormone-sensitive, particularly to steroids, which drive their growth and persistence. Consequently, the endometrium can show reactive changes in the presence of these uterine tumors. Objectives: This study aims to assess the histopathological alterations in the endometrium in the context of myometrial abnormalities, with a focus on identifying features that may help differentiate leiomyomas, adenomyosis, or coexisting conditions using endometrial curettage samples. Materials and Methods: This cross-sectional study involved 200 hysterectomy specimens obtained from women of reproductive age presenting with myometrial pathology. Upon receipt, each specimen underwent a thorough gross examination after fixation in formalin. Standard tissue processing techniques were applied, and sections of 5 microns thickness were prepared for microscopic analysis using hematoxylin and eosin (H&E) staining. Results: Leiomyomas were predominantly seen in women aged between 40 and 49 years, especially those with a history of multiple childbirths. Menorrhagia emerged as the most common presenting symptom. The endometrial histology varied with age and underlying lesion, with secretory phase changes being more frequent in women aged 45–49 years, and proliferative changes more commonly observed in the 40–44 age group. Degenerative features were noted in cases with both leiomyomas and adenomyosis. Conclusion: Given their dependence on steroid hormones, leiomyomas are typically associated with a proliferative or hyperplastic endometrium, reflecting an estrogen-dominant milieu. The link to multiparity suggests a contributory role of progesterone in tumor stability. Endometrial curetting showing features such as hyperplasia, cystically dilated or elongated glands, and interspersed smooth muscle fibres may point towards a diagnosis of leiomyoma, adenomyosis, or both. Keywords: Myometrial Lesions, Histopathology, Reproductive Age Group, Leiomyoma, Adenomyosis, Endometrial changes.

Background: Multiple sclerosis (MS) is a chronic autoimmune neurological disease marked by inflammation and demyelination in the central nervous system. Despite available immunosuppressive therapies, current treatments are insufficient in preventing disease progression. Ayurveda, particularly Panchakarma therapy, offers a holistic, detoxifying, and rejuvenative approach that may provide symptomatic relief and improve quality of life in MS patients. This study aims to develop an evidence-based algorithm for pain management in MS using Panchakarma. Materials and Methods: A four-year observational clinical study was conducted at Jeewakberg Rehabilitation Centre, Ranchi, involving 120 female patients aged 19–50 years diagnosed with MS. Panchakarma modalities—including Snehana, Swedana, Vamana, Virechana, Basti, Nasya, and Rasayana—were administered following classical protocols. Patients also received complementary interventions such as Yoga, Meditation, and Rasayana therapy. A stepwise treatment algorithm was developed based on classical Ayurvedic principles and tailored to patient-specific factors like disease stage, strength, and comorbidities. Results: Among the 120 participants, 80% of patients reported satisfactory improvement in pain, functional mobility, and overall well-being, with reduced dependence on corticosteroids. The remaining 20% showed limited benefit, mainly due to underlying psychiatric comorbidities such as depression, substance use, and social stigma. The Panchakarma regimen proved effective in reducing Vata aggravation, clearing Aama (toxins), and restoring Dhatu balance, thus supporting the pathophysiological framework of MS as Anukta Vatavyadhi. Conclusion: Panchakarma therapy, when systematically applied based on Ayurvedic diagnostics and protocols, can significantly enhance pain management and quality of life in MS patients. The proposed algorithm integrates classical Ayurvedic chikitsa with evidence-based practice and may serve as a complementary or alternative therapeutic pathway for long-term MS care. Further studies with larger sample sizes and control groups are warranted. Keywords: Multiple Sclerosis, Anukta Vatavyadhi, Panchakarma, Pain Management, Ayurveda, Autoimmune Neurological Disorder, Vata Vyadhi, Detoxification, Rasayana, Yoga

Background: Menstrual hygiene is an essential component of adolescent health, particularly in rural settings where cultural stigma and lack of education limit access to safe practices. Despite menstruation being a natural biological function, misconceptions and poor menstrual hygiene practices are still prevalent among adolescent girls. Objectives: To evaluate menstrual hygiene awareness and practices among school-going adolescent girls aged 15–19 years in the Hagare rural field practice area of a tertiary care center. Materials and Methods: A community-based cross-sectional study was conducted among 400 school-going adolescent girls selected through Probability Proportionate to Size (PPS) sampling. Data were collected via a structured, validated questionnaire. Descriptive and inferential statistics were applied using SPSS version 29.0.2.0. Results: Of the 400 participants, 76.75% had prior information on menstrual hygiene, predominantly from family and school. Sanitary pads were the most commonly used absorbent (82.25%). While 87.5% maintained genital hygiene, only 43.5% correctly identified the uterus as the source of menstrual blood. A statistically significant association was found between sanitary pad usage and age (p=0.013) and education level (p=0.0296). No significant associations were observed with mother’s education, type of school, or socioeconomic-status. Conclusion: The study reveals encouraging use of hygienic practices but highlights persistent knowledge gaps. Comprehensive menstrual health education programs are necessary to dispel myths and ensure access to safe hygiene facilities. Keywords: Menstrual hygiene, adolescent girls, sanitary pads, Menstrual practices, awareness.

Background: Acute respiratory distress syndrome (ARDS) is a serious postoperative complication following cardiac surgery under cardiopulmonary bypass (CPB), with systemic inflammation playing a pivotal role in its pathogenesis. Serum procalcitonin (PCT), a biomarker of inflammatory response, may have prognostic value in identifying patients at higher risk for ARDS in the postoperative period. The aim is to evaluate the association between elevated serum procalcitonin levels and the incidence of ARDS in patients undergoing cardiac surgery under cardiopulmonary bypass. Materials and Methods: This prospective observational study was conducted on 160 adult patients undergoing elective cardiac surgery under CPB. Based on 24-hour postoperative serum PCT levels, patients were divided into two groups: Group A (PCT <7 ng/mL) and Group B (PCT >7 ng/mL), with 80 patients in each group. Clinical, intraoperative, and postoperative parameters were compared. ARDS was diagnosed using the Berlin definition. Data were analyzed using SPSS v25, with p <0.05 considered statistically significant. Results: Group B patients had significantly longer CPB time (167.3 ± 80.1 min vs. 107.4 ± 34.6 min, p<0.001), higher incidence of ARDS (37.5% vs. 10%, p=0.001), and prolonged ICU stay (42.10 ± 33.2 hrs vs. 23.35 ± 3.7 hrs, p<0.001) compared to Group A. Mechanical ventilation time and hospital stay were also significantly increased. ROC analysis showed that a serum PCT level >10 ng/mL had an AUC of 0.891 for predicting ARDS, with 80.6% sensitivity and 76.1% specificity. Conclusion: Elevated serum procalcitonin levels are significantly associated with higher incidence and severity of ARDS in patients undergoing cardiac surgery under CPB. Procalcitonin may serve as a useful biomarker for early risk stratification and targeted monitoring in the postoperative period. Keywords: Procalcitonin, ARDS, Cardiopulmonary Bypass.

Background: The diagnosis of nephrotic syndrome in children often triggers significant psychological stress and anxiety in parents, especially during the initial episode. Emotional turmoil may affect their ability to make informed medical decisions and provide adequate care. Evaluating the degree of anxiety and distress among parents during this critical phase is essential for improving parental support systems and pediatric outcomes. Materials and Methods: A total of 50 parents of children diagnosed with the first episode of nephrotic syndrome were enrolled. Parental psychological distress was assessed using the Distress Thermometer (DT), and anxiety levels were measured using the Taylor Manifest Anxiety Scale (TMAS). Data on demographic characteristics, coping strategies, and psychological impact were recorded through structured interviews. Scores were categorized into mild, moderate, and severe levels of distress/anxiety, and correlations with coping behaviors were analyzed. Results: Out of 50 parents, 36% exhibited severe anxiety on the TMAS (score > 70), while 48% showed moderate levels (score 55–70), and only 16% reported mild anxiety (score < 55). On the Distress Thermometer, 60% scored ≥7, indicating high emotional distress. Common coping mechanisms included seeking social support (70%), information gathering (58%), and reliance on spiritual practices (42%). A significant correlation was observed between higher distress scores and maladaptive coping responses such as denial and emotional withdrawal (p < 0.05). Conclusion: The first episode of nephrotic syndrome in a child significantly impacts parental mental health, with a high prevalence of anxiety and distress. Psychological screening and timely counseling interventions are vital to support parents and optimize disease management. Incorporating routine mental health assessments in pediatric nephrology settings is recommended. Keywords: Distress, anxiety, first episode, nephrotic syndrome, parental coping, Taylor Manifest Anxiety Scale, Distress Thermometer.

Background: Anterior knee pain persists in 10–15% of patients following total knee arthroplasty (TKA) and can compromise patient satisfaction and function. Circumpatellar denervation using electrocautery to interrupt peripatellar nociceptive fibers has been proposed to reduce postoperative anterior knee pain without patellar resurfacing. Aim: To compare functional outcomes of primary TKA with versus without circumpatellar denervation, using measures of pain, range of motion, clinician‐rated scores, and patient‐reported outcomes. Materials and Methods: In this single‐center, prospective observational study, 40 osteoarthritic knees (20 undergoing circumpatellar denervation and 20 without) were evaluated over 18 months. Outcomes recorded preoperatively and at 6 weeks, 3 months, and 6 months postoperatively included Visual Analog Scale (VAS) for walking and stair‐climbing pain, range of motion (ROM), Objective and Functional Knee Society Scores (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Feller’s patellar score. Between‐group comparisons employed independent‐samples t-tests; paired t-tests assessed pre- versus postoperative changes. A p-value <0.05 denoted significance. Results: Pain Relief: Walking VAS decreased from 8.25 to 0.65 with denervation versus 8.55 to 1.25 without (p = 0.0178); stair‐climbing VAS fell from 9.30 to 0.45 versus 9.00 to 0.95 (p = 0.0136). Range of Motion: Mean postoperative ROM was 20.05° versus 19.60° (p = 0.0697). Clinician-Rated Scores: Objective KSS improved from 56.25 to 95.60 versus 57.40 to 92.85 (p = 0.0500); Functional KSS rose from 35.50 to 96.95 versus 34.05 to 93.55 (p = 0.0250). Patient-Reported Outcomes: WOMAC scores decreased from 68.35 to 9.70 versus 65.70 to 11.50 (p = 0.0250); Feller’s patellar score increased from 6.75 to 25.75 versus 7.15 to 24.00 (p = 0.0008). Conclusion: Circumpatellar denervation during primary TKA yields significantly greater early reductions in anterior knee pain and superior functional gains both clinician‐rated and patient‐reported—compared to standard TKA without denervation, without adversely affecting knee mechanics. These findings support its use as a simple adjunct technique to enhance postoperative recovery. Keywords: Knee osteoarthritis, total knee arthroplasty, patellar denervation, anterior knee pain.

Background: The lymphatic filariasis disease have become a serious and growing public health problem. Objectives: 1. To independently get coverage and compliance and to find out the reasons for non-compliance among the households surveyed. 2. To recommend corrective measures to enhance the treatment coverage in future rounds of MDA. Materials and Methods: The coverage surveys were conducted at the MDA implementation unit level blocks of the Durg district. Data collection was done with the help of standard questionnaire of state program officer. Results: The post MDA CES assessment of Durg district was carried out by using cross sectional study design. The result are highly significant differences (p-value<0.05) among the locations regarding the consumption of both Albendazole and DEC, prior information about MDA and awareness of Lymphatic Filariasis. Conclusion: The overall observations about the diseases of LF was considered to be good among the cross sectional study design. Based on present study despite consumption defferences, ther is no statistically significant difference in the proportion of people offered Albendazole or DEC across location. Keywords: Lymphatic filariasis, Awareness, Coverage, Compliance, Effective Compliance.

Background: Anesthesia techniques for lower limb surgery are critical in ensuring patient comfort, safety, and optimal surgical outcomes. Among the various anesthetic approaches, balanced combined spinal epidural anesthesia (BCSEA) has gained popularity for its efficacy and ability to provide both motor and sensory blockade. However, its comparative effectiveness against other regional anesthesia techniques, particularly in lower limb surgery, has not been thoroughly studied. This study aims to evaluate the clinical outcomes, advantages, and limitations of BCSEA in lower limb surgery by comparing it with other commonly used anesthesia techniques. The objective is to assess the efficacy, safety, and clinical outcomes of balanced combined spinal epidural anesthesia (BCSEA) in patients undergoing lower limb surgery, in comparison with traditional anesthesia methods such as general anesthesia (GA) and single spinal anesthesia (SSA). Materials and Methods: A prospective, randomized, controlled study was conducted on 100 patients scheduled for elective lower limb surgery. Patients were divided into three groups: Group A (BCSEA), Group B (General Anesthesia), and Group C (Single Spinal Anesthesia). Clinical outcomes including the onset and duration of sensory and motor blockade, intraoperative analgesia, and postoperative recovery times were evaluated. Side effects and complications, including hypotension, nausea, vomiting, and failure of anesthesia, were also compared. Results: Group A (BCSEA) showed faster onset and longer duration of both sensory and motor blockade compared to Group C (SSA), with minimal intraoperative complications. Group B (GA) had a higher incidence of nausea and vomiting, and longer recovery times compared to both regional anesthesia groups. The BCSEA group also reported better postoperative analgesia and a lower incidence of complications such as hypotension and respiratory depression. Conclusion: Balanced combined spinal epidural anesthesia is an effective and safe option for lower limb surgeries, providing superior sensory and motor blockade, fewer complications, and faster recovery compared to general anesthesia and single spinal anesthesia. BCSEA offers significant advantages in terms of postoperative analgesia and patient recovery, making it a preferred choice for lower limb surgical procedures. Keywords: Balanced combined spinal epidural anesthesia, lower limb surgery, regional anesthesia, general anesthesia, sensory blockade, motor blockade, postoperative analgesia.

Background: Laparoscopic appendectomy has become the standard surgical approach for the management of acute appendicitis in adults. Although minimally invasive, postoperative pain remains a significant concern, often requiring systemic opioids which may be associated with undesirable side effects. The transversus abdominis plane (TAP) block has emerged as a promising regional anesthesia technique to provide effective postoperative analgesia by targeting the nerves of the anterior abdominal wall. This randomized controlled trial was conducted to evaluate the analgesic efficacy of transversus abdominis plane block in adult patients undergoing elective laparoscopic appendectomy. Materials and Methods: In this prospective randomized study, 80 adult patients scheduled for elective laparoscopic appendectomy were randomly allocated into two groups. Group A received ultrasound-guided bilateral TAP block with 20 mL of 0.25% bupivacaine on each side at the end of surgery, while Group B received standard care without TAP block. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 1, 4, 8, 12, and 24 hours. Total opioid consumption and incidence of opioid-related side effects were recorded. Results: VAS scores at all postoperative intervals were significantly lower in Group A compared to Group B (p<0.05). The mean total opioid consumption in 24 hours was markedly reduced in the TAP block group. Additionally, the incidence of nausea, vomiting, and sedation was lower in Group A. No adverse effects related to TAP block were reported. Conclusion: The use of transversus abdominis plane block provides superior postoperative analgesia, reduces opioid requirement, and minimizes opioid-related side effects in adult patients undergoing laparoscopic appendectomy. TAP block is a safe, effective, and valuable component of multimodal analgesia for enhanced recovery in minimally invasive abdominal surgery. Keywords: TAP block, laparoscopic appendectomy, postoperative analgesia, randomized controlled trial, opioid-sparing, regional anesthesia.

Background: Inguinal hernia repair, particularly the Lichtenstein tension-free mesh repair, is one of the most commonly performed general surgical procedures worldwide. While highly effective, concerns remain regarding its potential impact on testicular perfusion due to mesh placement and manipulation of spermatic cord structures during surgery. The present study was undertaken to evaluate alterations in testicular perfusion following Lichtenstein hernia repair using Doppler ultrasonography as a non-invasive assessment tool. Materials and Methods: This prospective observational study was conducted over a period of 18 months and included adult male patients undergoing elective unilateral Lichtenstein inguinal hernia repair. Patients with bilateral hernias, recurrent hernias, or pre-existing testicular disorders were excluded. Testicular perfusion was assessed preoperatively and at postoperative intervals (1 week and 3 months) using color Doppler ultrasonography, evaluating parameters such as resistive index (RI), peak systolic velocity (PSV), and end diastolic velocity (EDV). Results: A total of 60 patients were enrolled. Preoperative Doppler studies demonstrated normal testicular perfusion parameters. Postoperative assessments revealed a transient increase in resistive index and decrease in diastolic flow at 1-week follow-up, suggestive of mild perfusion changes. However, at 3-month evaluation, Doppler parameters largely returned to baseline values, indicating restoration of testicular blood flow. No significant long-term alterations in testicular perfusion were observed. Conclusion: Lichtenstein hernia repair may cause transient alterations in testicular perfusion in the immediate postoperative period, but long-term testicular blood flow remains largely unaffected. Doppler ultrasonography serves as a reliable, non-invasive tool for monitoring testicular perfusion following inguinal hernia surgery. Keywords: Inguinal hernia repair, Lichtenstein mesh repair, testicular perfusion, Doppler ultrasonography, resistive index, spermatic cord.

Background: Uterine fibroids are a leading cause of hysterectomy worldwide. An efficacious and cost-effective medical treatment option may reduce hysterectomy-associated morbidity. The present study was undertaken to evaluate the efficacy of ormeloxifene in the medical management of AUB-L and compare it with combined hormonal contraceptives (CHC). Materials and Methods: It was a Prospective comparative study. A total of 76 women in the age group 35-45 years, having abnormal uterine bleeding due to leiomyoma (PBAC score >100) were included, and randomized into two groups. Women in one group were given Ormeloxifene 60 mg twice weekly for 6 months and in another group combined hormonal contraceptives containing ethinyl estradiol 30 μg with levonorgestrel 150 μg for 21 days starting from day 1 or 2 of the cycle, were given for 6 months. Participants were followed after 3months, 6 months and then at 9 months, that is 3 months after completion of treatment. Primary outcome measure was change in PBAC Score. Other outcomes noted were change in hemoglobin concentration, change in leiomyoma size and volume, changes in dysmenorrheal VAS score and satisfaction with treatment. Results: There was statistically significant decrease in PBAC score in both the groups at each follow-up visit, however the improvement was significantly more in ormeloxifene group (p value <0.05). The decrease in mean PBAC scores was 80.63 % in group 1 at 6 months and 63.45% in group 2. Similar observation was made in mean hemoglobin concentration. However, there was no statistically significant change in leiomyoma volume in either of the group at 6 months and at 9 months. prolonged cycles was the most common side-effect seen with ormeloxifene. Conclusion: Ormeloxifene is a non-steroidal, non-hormonal drug and an effective, safe and acceptable option for medical management of heavy menstrual bleeding associated with leiomyoma uterus. Keywords: Ormelexifene; Combined hormonal contraceptives (CHCs); Leiomyoma; Abnormal uterine bleeding.

Background: The aim is to evaluate the efficacy of dexmedetomidine and fentanyl as an appropriate sedative drug for Monitored Anaesthesia Care in Tympanoplasty (ENT surgeries). Materials and Methods: A total of 60 patients between the age group of 18-60 years were included in the study. They were ASA I &II and scheduled for the elective Tympanoplasty surgery under Monitored anaesthesia care. Patients were randomized into 2 groups, as group F (Fentany group) received Inj.Fentanyl 1μ/kg bodyweight I.V and group D (Dexmedetomidine) received dexmedetomidine 1μ/kg body weight infusion over 10 mins. Patients fasted at least 8 hours before operation and did not receive any pre-operative sedative drug. Results: Intra operatively & Post operatively SBP levels were relatively high in Dexmedetomidine group than fentanyl group and difference was statistically significant. DBP levels high at all times among dexmedetomidine group than fentanyl and diference was statistically significant and Post operatively there was statistically insignificant. MAP levels intra operatively higher at all times noted among dexmedetomidine group than the fantanyl Group and difference was statistically significant, Post operatively insignificant. Heart rate and SPO2 were Statistically insignificant intraoperatively and Post operatively. Pain and Discomfort scores are less at all times intraoperatively in dexmedetomidine group and there were statistically significant. Post operatively insignificant. sedation scores were less in dexmedetomine group at all till 45 mins s urgery and these were statistically significant than Fentanyl group. after 45 mins pain scores were similar and statistically insignificant. Conclusion: The present study demonstrates that dexmedetomidine is a safe and effective alternative to fentanyl for sedation in patients undergoing tympanoplasty under monitored anesthesia care. Keywords: Dexmedetomidine, Fentanyl, Tympanoplasty, Amaesthesia.

Background: Venous malformations (VMs) are the most common type of low-flow vascular malformation, often affecting the head and neck. These congenital lesions may not become symptomatic until later in life and can cause functional or cosmetic concerns. The aim is to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck. Materials and Methods: A retrospective/prospective analysis was conducted on patients diagnosed with venous malformations of the head and neck who underwent surgical intervention. Data collected included demographic information, lesion location and size, type of surgical approach, adjunct treatments (e.g., sclerotherapy), intraoperative findings, and post-operative outcomes. Imaging modalities such as MRI and Doppler ultrasound were used for diagnosis and surgical planning. Results: Most lesions were localized in the cheek, lips, or tongue. Complete excision was achieved in a majority of cases with minimal functional compromise. Some patients required combined treatment with preoperative sclerotherapy. Complications included minor wound infections and temporary nerve weakness in a few cases. A significant improvement in cosmetic and functional outcomes was observed post-surgery. Conclusion: Surgical excision remains a reliable and effective modality for treating symptomatic venous malformations in the head and neck. Multidisciplinary planning, proper imaging, and case selection are essential to optimize outcomes and minimize complications. Keywords: Venous malformation, head and neck, vascular anomaly, surgical management, low-flow malformation.

Background: Congenital anomalies are a significant cause of neonatal morbidity and mortality, particularly in low-resource settings. Genetic counselling plays a crucial role in educating parents about inherited disorders, associated risk factors, and available preventive and management options for these disorders. This study aimed to assess the types and risk factors of congenital anomalies and to evaluate the impact of genetic counselling on parental awareness. Materials and Methods: A descriptive observational study was conducted at Mahatma Gandhi Memorial Government Hospital, Tiruchirappalli, from February 2018 to July 2019, involving 182 neonates with congenital anomalies. Maternal history, clinical examinations, and imaging studies were used for the diagnosis. A structured questionnaire was used to assess parental awareness before and after the counselling sessions. Results: Cardiovascular anomalies were the most common (42.9%), with acyanotic lesions comprising 64.1% of these anomalies. Multiple anomalies were present in 31.4% of neonates, and consanguinity was reported in 31% of the cases. Maternal hypothyroidism and gestational diabetes were observed in 9.9% of pregnancies. Only 13.2% of mothers took folic acid preconceptionally, while 14.3% did not take it at all. Antenatal anomaly scans were performed in 68.1% of the cases. Genetic counselling was attended by 95.6% of the parents. Pre-counselling, 34.5% of parents scored below 7 in awareness, while 81% scored a maximum of 13 post-counselling. The neonatal survival rate was 64.8%, and 55.5% of families adhered to follow-up. Conclusion: This study highlights the high prevalence of congenital heart defects and multiple risk factors, including consanguinity and maternal metabolic conditions. Genetic counselling significantly improved parental awareness and understanding of congenital anomalies, as evidenced by marked post-intervention score improvements. Keywords: Congenital anomalies, Genetic counselling, Parental awareness, Consanguinity, Folic acid deficiency.

Background: Maternal diabetes mellitus and malnutrition are prevalent metabolic insults known to adversely affect placental development and fetal outcomes. This study was designed to compare the gross morphological changes in full-term placentas from these two distinct pathological conditions against those from normal pregnancies and correlate them with neonatal birth weight. Materials and Methods: A prospective, comparative study was conducted on 100 full-term placentas collected post-delivery. A systematic gross examination documented placental weight, diameter, umbilical cord length, and neonatal birth weight. Results: The results showed that the diabetic group exhibited a significant increase in mean placental weight, diameter, umbilical cord length, and neonatal birth weight when compared to the control group. Conversely, the malnourished group demonstrated a significant reduction in all these parameters. No significant differences were observed in the umbilical cord insertion site or the number of vessels across the groups. Conclusion: These findings demonstrate that maternal diabetes and malnutrition induce divergent morphological changes in the placenta, leading to fetal overgrowth (macrosomia) and growth restriction, respectively. This highlights the critical role of the maternal metabolic environment in determining feto-placental health and underscores the importance of targeted nutritional and glycemic management to ensure favorable neonatal outcomes. Keywords: Placenta, Diabetes, Malnutrition, Pregnancy, Malnourished.

Background: Trauma scoring systems, such as the Trauma and Injury Severity Score (TRISS), integrate physiological, anatomical, and age-related factors to quantify the severity of injury and predict patient outcomes. TRISS provides a standardised framework for trauma care, facilitating accurate prognostication. This study aimed to evaluate the effectiveness of TRISS in predicting mortality and morbidity outcomes in multiple trauma patients and compare its predictive accuracy with that of ISS and RTS. Materials and Methods: This longitudinal observational study included 100 patients with multiple traumas at Thiruvarur Medical College and Hospital over one year. The data collected included patient demographics, injury characteristics, RTS and ISS scores, initial and subsequent TRISS scores, and clinical outcomes (mortality, ICU admission, surgical intervention, and hospital stay duration). Results: Males predominated (60%), and the most affected age group was 41–50 years (22%). Blunt injuries were the most common, primarily caused by road traffic accidents (64%), and affected the extremities (55%), abdomen (56%), and head (52%). The ICU admission rate was 30%, and mortality occurred in 13% of the patients. The mean ISS was significantly higher in fatalities (40.08) than in survivors (6.34, P < 0.001). ROC analysis demonstrated high predictive accuracy for all scoring systems, with AUC values of 1.00 for ISS and TRISS and 0.95 for RTS. An ISS cutoff of 27.5 and a TRISS cutoff of 82.5 demonstrated perfect discrimination for mortality prediction. Conclusion: This study validated the high accuracy of the TRISS in predicting trauma outcomes, showing strong correlations with ISS and RTS scores. These findings reinforce the value of the TRISS in guiding trauma care decisions, although periodic recalibration is necessary to adapt to evolving trauma management practices. Keywords: Trauma and Injury Severity Score (TRISS), Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma severity assessment, Mortality prediction, ROC curve analysis.

Background: Age-related macular degeneration (AMD) and cataract frequently coexist in the elderly, contributing to significant visual disability. While cataract surgery is known to improve visual acuity, its impact on quality of life (QoL) in patients with concurrent AMD remains an area of clinical interest. Objective: To evaluate the effect of cataract surgery on visual outcomes and quality of life in elderly patients diagnosed with AMD. Materials and Methods: This prospective observational study included 100 patients aged ≥60 years with clinically significant cataract and concurrent AMD. All patients underwent standard Small Incision Cataract Surgery (SICS) with intraocular lens implantation. Best corrected visual acuity (BCVA) and vision-related quality of life were assessed preoperatively and at 3 months postoperatively using the NEI VFQ-25 questionnaire. Subgroup analysis was performed for dry and wet AMD cohorts. Results: The mean age of participants was 71.6 ± 6.4 years, with 58% males. Dry AMD was present in 76% and wet AMD in 24% of patients. Postoperative BCVA showed significant improvement (0.86 ± 0.21 vs. 0.49 ± 0.19 logMAR; p < 0.001). NEI VFQ-25 composite score increased from 41.2 ± 6.4 to 64.7 ± 8.9 (p < 0.001), with marked gains across all domains. Patients with dry AMD had greater QoL improvement than those with wet AMD (66.4 vs. 58.2; p = 0.02). Conclusion: Cataract surgery significantly enhances visual function and quality of life in elderly patients with AMD, particularly in those with dry AMD. It should be considered a valuable intervention despite underlying macular pathology. Keywords: Cataract surgery, macular degeneration, quality of life, elderly, NEI VFQ-25, visual acuity.

Background: Neuroendocrine Tumours (NETs) are a heterogeneous group of tumours with diverse biology and clinical behaviours that vary according to tumour site, type of neuroendocrine cells and grading of the tumour. Materials and Methods: A retrospective, observational study was carried out at the Department of Pathology, Shri Ram Murti Smarak (SRMS) Institute of Medical sciences (IMS), Bareilly. All the cases diagnosed as neuroendocrine tumour or neuroendocrine carcinoma (NEC) from January 2022 to December 2024 were included. Typing of the tumour was done according to WHO classification. We used Chromogranin A (CgA), Synaptophysin, CD56 and Ki67 Immuno-histochemical markers for confirmation of neuroendocrine etiology. Results: The study composed of total 52 cases which were archived from the Hospital Information System. The maximum number of cases were belonged to gastrointestinal tract (28.84%) followed by lung and gall bladder each comprised of 11.53%. In our study 25% cases are of grade 1 NET, 15.4% of grade 2 NET, 13.4% of grade 3 NET and 46.20% of poorly differentiated neuroendocrine carcinoma. Most of the grade 1 and 2 tumours are positive for all the three markers with strong and diffuse positivity and Ki67 proliferative index was in the range of 2-3% and 6-15% respectively. Grade 3 tumours, small cell NEC and large cell NECs were also showed positivity for all the neuroendocrine markers with somewhat reduced intensity as compared to grade 1 & 2 tumours and Ki67 proliferative index was in the range of 40-90%. Conclusion: The effective application of WHO grading and immunomarkers like Chromogranin A, Synaptophysin, CD56, and Ki-67 proved essential for accurate diagnosis and classification. Overall, the findings offer valuable insight into regional NET patterns and call for further multicentric and longitudinal research to improve patient management. Keywords: Neuroendocrine Tumours (NETs), Immunohistochemistry markers, Chromogranin A (CgA), Synaptophysin, CD56, Ki67.

Background: Diabetic ketoacidosis (DKA) is an acute complication of uncontrolled diabetes mellitus (DM). Abdominal symptoms and elevated pancreatic enzyme levels are common. The elevations of serum amylase and lipase levels in DKA can mimic acute pancreatitis, making diagnosis a challenge. This study aimed to compare serum amylase and lipase levels in DKA and non-DKA cases. Materials and Methods: This cross-sectional observational study included 40 patients with diabetes, of whom 9 had DKA and 31 did not. They were evaluated clinically using biochemical variables (serum amylase and lipase), arterial blood gases, and abdominal imaging (ultrasound and CT as needed). The enzyme levels of the groups were compared, and correlations with indicators of DKA severity were analyzed. Results: Patients with DKA showed a significant increase in blood glucose and anion gap levels and a decrease in pH and bicarbonate levels (p<0.001). Serum amylase and lipase levels were also significantly higher in the DKA group (248.6 ± 102.7 U/L and 162.4 ± 78.5 U/L, respectively; p<0.001). The higher the acidosis, the higher the enzyme levels. However, no pancreatic inflammation was detected by imaging studies in any of the cases, even in those with enzyme concentrations >3X above the upper limit of normal. Cases of abdominal pain were strikingly more common in DKA, which was not unique to pancreatitis. Conclusion: Elevated serum amylase and lipase levels are common in DKA and correlate with the severity of metabolic derangement rather than true pancreatitis. Clinicians should interpret these enzyme elevations cautiously and rely on clinical and imaging findings to avoid misdiagnosis and unnecessary interventions. Keywords: Diabetic Ketoacidosis (DKA), Serum Amylase, Serum Lipase, Acute Pancreatitis.

Background: Timely and accurate monitoring of labor is critical for preventing maternal and fetal complications. The WHO-modified partograph is a visual tool designed to aid in assessing labor progression and identifying deviations that may necessitate intervention. This study aimed to evaluate the effectiveness of the WHO-modified partograph in monitoring labor patterns and improving maternal outcomes. Materials and Methods: A prospective observational study was conducted over 18 months at Northern Railway Central Hospital, New Delhi, involving 100 women (50 primigravida, 50 multigravida) with uncomplicated singleton term pregnancies and spontaneous labor onset. Labor progression was recorded using the WHO-modified partograph. Patients were categorized based on labor progression zones: Zone A (left of alert line), Zone B (between alert and action lines), and Zone C (right of action line). Outcomes were analyzed in terms of labor duration, mode of delivery, and maternal morbidity. Results: Normal labor progression was seen in 85% of cases, with 97.4% in Zone A having normal labor pattern. Abnormal labor patterns (15%) were significantly associated with delivery in Zones B and C. Cesarean and instrumental delivery rates increased markedly beyond the alert line, with maternal morbidity (fever, wound sepsis) significantly higher in the abnormal labor group (p < 0.001). The average labor duration was significantly shorter in the normal group (9.57 hours vs. 17.05 hours, p < 0.001). Conclusion: The WHO-modified partograph is a reliable, low-cost, and effective tool for monitoring labor. It enables early detection of deviations from normal labor, facilitating timely interventions that can reduce the risk of complications and improve maternal outcomes. Keywords: Partograph, Maternal outcomes, Abnormal labor.

Background: Acute kidney injury (AKI) in neonates is a serious and potentially life-threatening condition that often arises in the context of sepsis, perinatal asphyxia, and other neonatal complications. Early identification and appropriate management are crucial to reduce morbidity and mortality. This study aimed to determine the aetiological profile, clinical characteristics, and outcomes of AKI among neonates admitted to a tertiary care NICU in India. Materials and Methods: A Retrospective observational study was conducted in the NICU of a tertiary care hospital over a 24-month period (August 2022 to July 2024). A total of 3200 neonates were screened, of whom 168 met the criteria for AKI based on modified KDIGO definitions. Demographic data, clinical and laboratory parameters, etiology of AKI, interventions, and outcomes (recovery, mortality, and progression to chronic kidney disease) were recorded and analyzed. Results: Among 168 neonates with AKI, the mean age was 5.3 ± 3.1 days, with a male predominance (58.3%). The leading causes of AKI were sepsis (48.8%), perinatal asphyxia (32.1%), and dehydration/ hypovolemia (26.2%). The majority of cases were intrinsic renal AKI (56%), followed by prerenal (41.1%) and postrenal (3%). Laboratory findings showed elevated serum creatinine (1.8 ± 0.5 mg/dL) and BUN (48.5 ± 12.7 mg/dL), with 36.3% showing metabolic acidosis. Interventions included antibiotics (88.1%), fluid resuscitation (60.7%), and peritoneal dialysis in 14.3%. Complete renal recovery was seen in 64.2% of cases, while 4.8% progressed to chronic kidney disease. The overall mortality rate was 30.9%, significantly higher among those with intrinsic renal AKI (p < 0.0001). Conclusion: Sepsis and perinatal asphyxia remain the most common etiological factors for neonatal AKI in Indian NICUs. Intrinsic renal AKI is associated with significantly higher mortality. Early diagnosis and prompt management are essential to improve outcomes and reduce long-term renal complications in this vulnerable population. Keywords: Neonatal acute kidney injury, NICU, sepsis, perinatal asphyxia, renal outcome, intrinsic renal AKI, neonatal mortality, India.

Background: The treatment for plantar fasciitis (PF), a prevalent cause of heel discomfort, is not yet standardized. Despite being the two most often utilized methods, platelet-rich plasma (PRP) and corticosteroid (CS) injections, little attention has been paid to comparing their contributions to long-term functional improvement. Materials and Methods: 56 cases of plantar fasciitis in all, divided into two groups of 28 participants each, were included in the study from the outdoor orthopaedics department. Following a straightforward randomization process using computerized random numbers, participants were randomized to one of two treatment groups. Results: There were no notable differences between the therapy groups, according to demographic data. When compared to corticosteroid therapy, PRP therapy consistently produced lower Visual Analog Scale (VAS) pain scores at all follow-up intervals. Furthermore, PRP-treated patients had higher Foot and Ankle impairment Index (FADI) ratings, indicating a larger improvement in functional impairment. Over the course of the trial, patient satisfaction was noticeably better in the PRP group. The two groups experienced comparable adverse effects. Conclusion: When compared to corticosteroid injection therapy for plantar fasciitis, PRP injection therapy is more effective at lowering pain intensity, improving functional impairment, and raising patient satisfaction.Moreover, the safety profile of PRP therapy is similar.These results support the use of PRP as a recommended therapeutic alternative in clinical settings. Keywords: Injections of corticosteroids, plantar fasciitis, platelet-rich plasma, the degree of pain, and functional impairment

Background: Alpha 2 adrenergic agonists are added to local anaesthetics to increase the duration of block and provide better analgesia. The present study was aimed at comparing dexmedetomidine and clonidine as adjuvants to levobupivacaine in nerve stimulator guided supraclavicular brachial plexus block (SCBPB) in patients undergoing upper limb surgeries. Materials and Methods: 80 adult patients of age group 18-60 years, belonging to American society of anesthesiologists (ASA) grade I & II undergoing upper limb surgeries under nerve stimulator guided supraclavicular block were included in the study. Each group consisting of 40 patients received 30 ml of 0.5% levobupivacaine with clonidine 1 μg/kg diluted to 1 ml of NS (Group LC) and 30 ml of 0.5% levobupivacaine with dexmedetomidine 1μg/kg diluted to 1 ml of NS (group LD) with nerve stimulator guided supraclavicular brachial plexus block. The onset and duration of sensory and motor block and VAS score was compared in both the groups. Results: The onset of motor and sensory block was comparable in both the groups. The duration of sensory block and motor block was significantly prolonged in group LD in comparison to group LC (p <0.0001, p <0.0001). VAS score was significantly lower in group LD at 5,6 and 9 hrs (p <0.0001) Conclusion: 1mcg/kg dexmedetomidine is superior to 1 mcg/kg clonidine as an adjuvant to levobupivacaine in nerve stimulator guided supraclavicular brachial plexus block as it provides longer duration of sensory block, motor block and lower VAS score. Keywords: Dexmedetomidine, clonidine, sensory block, motor block, analgesia.

Background: Inflammatory Bowel Disease (IBD), encompassing Crohn's Disease and Ulcerative Colitis, poses unique challenges during pregnancy due to its chronic inflammatory nature and potential for disease flares. Understanding the impact of IBD on fetomaternal outcomes is crucial for optimizing prenatal care and management strategies. Materials and Methods: This retrospective study analyzed data from 39 pregnant women with IBD, including 12 with Crohn's Disease and 27 with Ulcerative Colitis. Demographic characteristics, clinical variables, and pregnancy outcomes were assessed. Logistic regression analysis was used to identify predictors of adverse outcomes, adjusting for potential confounders. Results: Women with Crohn's Disease exhibited significantly higher rates of disease flare-ups during pregnancy compared to those with Ulcerative Colitis (58.3% vs. 14.8%, p=0.011). Crohn's Disease was associated with increased odds of adverse outcomes compared to Ulcerative Colitis (adjusted OR 1.75, 95% CI 1.05-2.91, p=0.030). Corticosteroid use during pregnancy (adjusted OR 2.1, 95% CI 1.20-3.67, p=0.010), previous IBD-related surgeries (adjusted OR 1.9, 95% CI 1.05-3.42, p=0.044), and disease flare-ups (adjusted OR 2.5, 95% CI 1.30-4.80, p=0.013) were significant predictors of adverse outcomes. Maternal demographics, including age, BMI, smoking status, and parity, showed no significant associations with adverse outcomes. Conclusion: Pregnant women with Crohn's Disease are at heightened risk for adverse fetomaternal outcomes compared to those with Ulcerative Colitis, particularly when disease activity is not adequately controlled. Optimal disease management, including careful monitoring and individualized treatment plans, is essential to mitigate risks and improve pregnancy outcomes in this population. Keywords: Inflammatory Bowel Disease, Crohn's Disease, Ulcerative Colitis, pregnancy outcomes, disease flare-ups, corticosteroids, adverse outcomes.

Background: Acute fatty liver of pregnancy (AFLP) is a rare but serious condition characterized by maternal hepatic dysfunction, often leading to severe complications for both mother and fetus. Understanding the clinical manifestations and outcomes of AFLP is crucial for optimizing management strategies and improving maternal and neonatal outcomes. Materials and Methods: This retrospective cohort study analyzed data from 47 patients diagnosed with AFLP between January 2019 and December 2023 tertiary care center. Demographic characteristics, clinical presentations, laboratory findings, maternal outcomes, and neonatal outcomes were systematically reviewed. Statistical analyses, including descriptive statistics, Chi-square tests, and t-tests, were performed to assess associations and outcomes. Results: Among the 47 patients included, the mean age was 28.5 years (± 4.2), with 42.6% primiparous and 57.4% multiparous. Common presenting symptoms included vomiting (80.9%), abdominal pain (63.8%), and jaundice (53.2%). Maternal complications were frequent, with 21.3% experiencing hepatic encephalopathy, 31.9% acute renal failure, and 42.6% requiring ICU admission. Neonatal outcomes varied, with 42.6% born prematurely and 38.3% requiring NICU admission. Comparative analyses between early (<34 weeks) and late (≥34 weeks) diagnoses showed significant differences in gestational age at delivery (36.8 ± 2.1 weeks vs. 35.4 ± 2.4 weeks, p = 0.038) and birth weight (2650 ± 600 g vs. 2250 ± 700 g, p = 0.025), emphasizing the impact of timing on neonatal outcomes. Conclusion: This study underscores the severe maternal and neonatal implications of AFLP, highlighting the critical need for early recognition and multidisciplinary management. Biomarkers such as liver enzymes and clinical symptoms play a crucial role in predicting disease severity and guiding therapeutic interventions. Keywords: Acute fatty liver of pregnancy, maternal outcomes, neonatal outcomes, biomarkers, early diagnosis.

Background: Vitamin D plays a vital role in Calcium homeostasis, protein synthesis, and bone metabolism. Despite abundant sunlight in India, Vitamin D deficiency remains highly prevalent, warranting investigation into its biochemical correlations. Objectives: To assess the serum levels of 25-hydroxyVitamin D [25(OH)D] in adults and evaluate its association with biochemical parameters—namely, serum Calcium, Total Protein, and Albumin. Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in Bareilly, Uttar Pradesh, enrolling 150 adults aged 20–50 years. Serum 25(OH)D concentrations were categorized as deficient (<12 ng/mL), insufficient (12–20 ng/mL), or sufficient (>20 ng/mL). Biochemical markers were analyzed, and group differences were evaluated using one-way ANOVA. Results: Among the participants, 18% were Vitamin D deficient and 24.7% were insufficient. Mean 25(OH)D levels were similar between females (28.28 ± 20.71 ng/mL) and males (28.19 ± 20.83 ng/mL). Although no statistically significant differences were observed across Vitamin D categories, the deficient group consistently exhibited lower mean levels of serum Calcium, protein, and Albumin. Conclusion: A substantial proportion of the study population had suboptimal Vitamin D levels, accompanied by modest biochemical alterations. Our study suggest that routine screening and preventive strategies may be warranted even in asymptomatic individuals, given Vitamin D’s broader implications on health. Keywords: Vitamin D Status, Sun-Rich Population, Biochemical Parameters.

Background: Optimal head elevation is crucial for successful endotracheal intubation using direct laryngoscopy. The sniffing position, achieved by aligning the external auditory meatus with the sternal notch, enhances glottic visualization. Traditionally, a fixed-height pillow is used, but individual anatomical variations may affect its efficacy. Customised pillow height may offer better alignment and improved visualization. This study compares customised versus fixed-height pillows for optimizing glottic view during intubation. This prospective study compared a fixed height pillow (FP) with a customised height support (CP) created by adding sheets to achieve optimal head elevation—defined as horizontal alignment of the external auditory meatus (EAM) with the sternal notch—for endotracheal intubation in the sniffing position. Primary evaluation focused on the success of achieving this alignment, while secondary measures included glottic view by Cormack Lehane grade, time to successful intubation, and the requirement for adjuncts (bougie use, external laryngeal manipulation) or additional intubation attempts. Materials and Methods: This one-year prospective randomized comparative study was conducted in the Anaesthesiology Department at North Bengal Medical College, Siliguri, with ethical approvals in place. It included 130 adult patients (aged 16–60 years, ASA I and II) from the General Surgery and Orthopaedics departments, undergoing elective surgeries requiring endotracheal intubation. Results: The demographic and baseline characteristics, including age, weight, height, BMI, and airway parameters, were statistically comparable between the fixed pillow (FP) and customised pillow (CP) groups, ensuring group homogeneity. The Modified Mallampati (MMP) grade distribution was also similar at baseline. Among patients with favourable laryngoscopic views (CL grades 1 and 2), there were no significant differences in MMP grade distribution or intubation time between groups. However, in cases with difficult laryngoscopic views (CL grade ≥3), the customised pillow group had a significantly higher proportion of patients with easier MMP grades (Grade 1 and 2) and a much lower proportion with difficult MMP Grade 3, indicating a notable advantage of the customised pillow in challenging airway scenarios. Conclusion: This study found that both groups were comparable in baseline characteristics, ensuring differences were due to the pillow strategy. While glottic exposure and intubation speed were similar in routine cases, the customised pillow improved airway management in difficult views by shifting patients into easier Mallampati classes. Therefore, customised head elevation offers clear benefits in challenging cases without drawbacks in routine ones. Keywords: Glottic Visualization, Endotracheal Intubation, Sniffing Position, Customized Pillow Height and Direct Laryngoscopy.

Background: Organophosphates are commonly used for suicide by poisoning in India. Early recognition of the diagnosis and its severity will help in achieving a better outcome. Currently, Pseudocholinesterase are widely accepted as biochemical marker to estimate OP poisoning severity, which is sensitivity, but not specificity and costly investigation. Since Organophosphates effect multiple organs, this study aimed to find out that the possibility of using a wide array of alternate, cheap and easily available markers like serum creatine phosphokinase (CPK), pancreatic enzymes (serum amylase and lipase), liver enzymes (AST, ALT, ALP) in comparison with pseudocholinesterase in diagnosis and prognosis of oragnophosphorus compound poisoning. The objective is to estimate the serum levels of Creatine phosphokinase, Liver enzymes (AST, ALT, ALP), Pancreatic enzymes (serum amylase and lipase), and Pseudocholinesterase in patients with Organophosphorus compound poisoning. to correlate all investigations with Pseudocholinesterase in diagnosis and prognosis of OP poisoning. Materials and Methods: This Correlative study included 100 in patients with Organophosphates poisoning Admitted in K. R. HOSPITAL, MMC&RI, MYSORE during Study period of April 2023 to September 2024. Clinical manifestations including myopathy / muscle injury, acute pancreatitis, liver dysfunction were assessed. Biochemical markers (serum creatine phosphokinase, serum amylase and lipase, AST, ALT, ALP) were measured. Statistical analyses were performed to evaluate the association between these parameters. Results: The study population was predominantly female (58%) with a mean age of 38.5 years. majority of patient (70%) had myopathy or muscle injury with elevated CPK (r = -0.573,p = 0.000), 62 % of study subjects had acute pancreatitis with elevated serum amylase (r = -0.454, p = 0.000): and serum lipase (r = -0.446, p = 0.000), while 56 % patients had hepatic dysfunction with elevated serum AST(r = -0.455, p = 0.000), serum ALT (r = -0.450, p= 0.000), serum ALP (r = -0.361, p = 0.000).All these various biochemical markers showed a perfect negative correlation with Pseudocholinesterase with significant p valve. Conclusion: This study proves that, there is a significant derangement of various biochemical markers like creatine phosphokinase (CPK), serum amylase, serum lipase, serum Aspartate Aminotransferase (AST), Serum Alanine Aminotransferase (ALT) and Serum Alkaline Phosphatase (ALP) in acute OP compound poisoning patients. Hence these various biochemical markers which are cheaper, and easily available can be used as potential biochemical markers for diagnosis and assessing the severity of organophosphate poisoning. Keywords: Organophosphate poisoning, CPK, AST, ALT, ALP

Background: Breast lesions encompass a wide spectrum ranging from benign to malignant conditions. Fine needle aspiration cytology (FNAC) plays a pivotal role in the initial diagnosis of these lesions. Correlating FNAC findings with histopathology helps validate its diagnostic utility. The objective is to study the spectrum of breast lesions encountered at a tertiary care hospital in Thiruvarur and evaluate the cytohistologic correlation. Materials and Methods: A retrospective study was conducted over two years, including patients who underwent FNAC followed by histopathological examination. FNAC results were categorized using the IAC Yokohama System, and histopathology served as the gold standard. Diagnostic indices of FNAC were calculated. Results: A total of 120 breast lesions were evaluated. The age of patients ranged from 15 to 75 years. Benign lesions constituted 65%, while 30% were malignant and 5% were atypical or suspicious. The most common benign lesion was fibroadenoma, and invasive ductal carcinoma was the predominant malignant lesion. The overall cytohistologic concordance was 90%. FNAC showed a sensitivity of 95.3%, specificity of 97.6%, and accuracy of 96.1%. Conclusion: FNAC is a reliable, cost-effective, and minimally invasive diagnostic tool for breast lesions. High cytohistologic concordance underscores its importance in early diagnosis, especially in resource-limited settings. Keywords: Breast lump, FNAC, malignancy.

Background: Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose, which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves, the most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. As type 2 Diabetes starts to develop, the body becomes less sensitive to insulin and the resulting insulin resistance also leads to inflammation. This study aimed to find out that, is there any significant degree of inflammation found with the subjects of Type 2 diabetes mellitus and is it correlating with control status and complications. The objective is to estimate the levels of chronic inflammatory parameters in subjects of Type 2 Diabetes Mellitus. B. To correlate the chronic inflammatory parameters with that of control status and complications of Type 2 Diabetes Mellitus. Materials and Methods: A Cross sectional – observational study design to know the chronic inflammation in Type 2 Diabetes mellitus patients and its correlation with complications. 90 patients admitted with Type 2 Diabetes mellitus in K R Hospital, Mysore medical college and research institute from April 2023 – September 2024. Results: In present study it was found that microalbuminuria is present in 67 individuals (74.4%), Hypertension in 50 individuals (55.6%), retinopathy is seen in 46 individuals (51.1%), nephropathy in 36 individuals (40%), IHD in 24 individuals (26.7%), CVA in 10 individuals (11.1%). The results show that individuals with microalbuminuria, HTN, retinopathy, nephropathy, IHD and CVA have significantly higher mean levels for ESR, CRP, LDH and S. Ferritin and lower levels of S. albumin which is significant and a p- value of 0.001. Conclusion: This study provides impeccable evidence that, the chronic inflammation is associated with multiple complications in T2DM patients. Elevated chronic inflammatory markers are correlating with worsening kidney function, cardiovascular risks, and microvascular complications, emphasizing the need for inflammation-targeted therapeutic strategies to mitigate the long-term burden of diabetes-related complications. Keywords: HTN, CVA, IHD, Chronic inflammation.

Background: Severe acute malnutrition (SAM) and anemia are major public health concerns, significantly affecting growth and development in children under five. This study examines the clinical and etiological factors contributing to anemia in children with SAM in South Gujarat, with a focus on iron and vitamin B12 deficiencies. The aim is to document the profile of anemia and various etiological factors among children with malnutrition, 2) To evaluate iron status in severely malnourished children with anemia, and 3) To assess vitamin B12 levels in severely malnourished children with anemia. Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in South Gujarat from June 2019 to October 2020. A total of 120 children aged 6 months to 5 years with SAM were enrolled. Anthropometric measurements, clinical evaluations, and biochemical tests for hemoglobin, serum iron, total iron-binding capacity, and vitamin B12 were performed. Anemia was classified based on hemoglobin levels, and deficiencies were identified using standard biochemical thresholds. Data were analyzed using SPSS, applying Chi-square tests for association. Results: Of the 120 children, 61.7% had moderate anemia, and 38.3% had severe anemia. Iron deficiency was present in 46.6%, while 28.3% had vitamin B12 deficiency. Severe anemia was significantly associated with low vitamin B12 levels (52.9%; p = 0.039) and inadequate dietary B12 intake (p = 0.027). Anemia was higher among females (55%) and children from lower socioeconomic groups (63.4%). Conclusion: Vitamin B12 deficiency is a significant contributor to anemia among children with SAM. Treatment of SAM child with anemia should also focus on vitamin B12 supplementation along with Iron and Folic acid. Keywords: Severe acute malnutrition, anemia, iron deficiency, vitamin B12 deficiency, under-five children.

Background: Aim: To evaluate the role of DW-MRI in differentiating benign and malignant breast lesions. Materials and Methods: Fifty-five female subjects with sixty-five breast lesions underwent MR with T2W fat sat and DWI of the breasts using b (0,600) value. The computed mean apparent diffusion coefficients (ADC's) of the breast lesions were correlated with histopathology. Statistical analysis was done by independent variable t test and ROC curves. Results: Mean ADC values of those with benign lesions was 1.47 ± 0.21 x 10-3 mm2 /sec and those with malignant lesions was 0.85 ± 0.28 x 10-3 mm2 /sec. There was significant difference in mean ADC between benign and malignant lesions. ADC was high in benign lesions and low in malignant lesions. By considering ADC cut off as 1.131 x 10-3 mm2 /sec the sensitivity and specificity in the differentiating malignant from benign breast lesions was 90.48% and 95.65%, respectively. Conclusion: DWI with ADC values is easy to obtain in short scan time and can differentiate between benign and malignant breast lesions with high sensitivity and specificity. Keywords: MRI, Malignant breast lesions, Breast Cancer, tissues.

Background: Essential newborn care practices are critical for reducing neonatal morbidity and mortality, particularly in developing countries like India, where traditional beliefs can influence their adoption. This study investigated newborn care practices and associated factors in rural communities of Patna district, Bihar, India. Materials and Methods: A community-based cross-sectional study was conducted between January and June 2023. A total of 289 mothers who had delivered a live baby within the preceding six months were recruited using multi-stage random sampling. Data were collected via face-to-face interviews using a semi-structured questionnaire, assessing socio-demographic characteristics, antenatal care history, delivery details, and newborn care practices (cord care, breastfeeding, thermal care, and bathing). Data were analyzed using SPSS 20.0 with descriptive statistics and logistic regression. Results: The mean maternal age was 26.2 years; 40.8% of mothers had no formal education. Forty-six percent initiated breastfeeding within one hour of birth, and 43% practiced dry cord care. Skin-to-skin contact was established in 38.1% of cases immediately after birth. Only 34.5% of babies were exclusively breastfed for the first six months. Practices such as applying mustard oil to the cord (26%) and pre-lacteal feeding (31.1%) were prevalent. Factors like maternal education, institutional delivery, and adequate antenatal care visits were positively associated with better newborn care practices. Conclusion: The study highlights a gap between recommended and actual newborn care practices in rural Patna, influenced by traditional beliefs and socio-demographic factors. Interventions focusing on health education, promotion of institutional deliveries, and targeted counseling are crucial to improve newborn health outcomes. Keywords: Newborn Care, Rural Communities, Traditional Practices.

Background: Animal bites remain a significant public health concern in India, with rabies being a fatal yet preventable consequence. Understanding the clinico-social profile of animal bite victims is crucial for effective intervention strategies. Objective: This study aimed to assess the clinico-social profile of animal bite cases attending the anti-rabies clinic of a tertiary care hospital. Materials and Methods: A hospital-based cross-sectional study was conducted at the anti-rabies clinic of a tertiary care hospital. A pre-tested questionnaire was used to collect data on socio-demographic characteristics, details of the animal bite incident, and first aid practices. Data analysis was performed using SPSS version 20. Results: A total of 378 animal bite cases were included in the study. The majority of victims were males and belonged to the age group of >15 years. Dog bites were the most common (around 85%), with stray dogs being responsible for a significant proportion. Lower limbs were the most frequent bite site, and a high percentage of cases presented with Category III exposures. A considerable proportion of victims reported from rural areas and had not adopted appropriate first aid measures. Conclusion: The study highlights the predominance of dog bites, severity of exposures, and inadequate first aid practices among animal bite victims attending the tertiary care hospital. These findings underscore the need for targeted public health awareness campaigns, particularly in rural areas, focusing on responsible pet ownership, stray dog management, and the importance of immediate and appropriate wound care following animal bites. Keywords: Animal Bites, Clinical Profile, Social Profile, Rabies, Tertiary Care Hospital.

Background: Family planning is crucial for maternal and child health. Understanding the factors influencing its adoption among mothers is essential for designing effective interventions. Objective: This study aimed to assess the knowledge, attitude, and practice of family planning methods and identify associated factors among mothers attending the immunization clinic of a medical college. Materials and Methods: A cross-sectional study was conducted among a sample of 354 mothers attending the immunization clinic of a medical college in Patna. Data on socio-demographic characteristics, knowledge, attitude, and practice of family planning methods, and perceived barriers were collected using a structured questionnaire. Statistical analysis was performed using descriptive and inferential statistics, including chi-square tests and logistic regression, to identify factors associated with family planning practices. Results: A high level of awareness regarding family planning methods was observed, but the utilization rate was lower, with an overall prevalence of contraceptive use at 53.4%. Female sterilization (18.6%) and male condoms (12.7%) were the most commonly practiced methods. Factors such as maternal education (p=0.01), age (p=0.03), residing in a nuclear family (p=0.04), and having two or more living children (p=0.01) were found to be significantly associated with the practice of family planning. Fear of side effects (30.3%) and desire for more children (36.4%) were identified as key barriers to adoption. Conclusion: While awareness of family planning is high, efforts need to focus on addressing barriers like fear of side effects and enhancing male involvement to improve adoption rates among mothers. Tailored interventions considering socio-demographic factors are essential for promoting effective family planning practices. Keywords: Family Planning, Mothers, Immunization Clinic, Influencing Factors, Awareness, Practice.

Background: APACHE II is the most widely used ICU scoring system helpful in predicting outcomes. CT severity index (CTSI) is a radiological scoring system which stratifies the severity of pancreatitis. It is useful in identifying the persons who need immediate surgical intervention. Comparison of both indices in patients with acute alcoholic pancreatitis in prediction of outcomes is the primary aim of this study. Materials and Methods: Data of 75 patients was collected retrospectively from the health records. APACHE II scores were calculated based on the physiological parameters and biochemical markers measured within 24 hours of admission in the hospital. CECT scans of all patients were analyzed and CTSI was calculated. Appropriate statistical methods were employed to compare the predicting efficacy of both scoring systems. Results: Although both APACHE II and CTSI were correlating significantly with the clinical outcomes, higher APACHE II scores were associated with higher rates of mortality and CTSI scores above 0.83 was indicative of need of surgical intervention. Conclusion: Both APACHE II and CTSI scoring systems are excellent indicators of outcomes in patients with acute alcoholic pancreatitis. APACHE II scores utilize the physiological derangements while CTSI analyzes the anatomical abnormalities. Application of both scores will enable the treating physician to triage the patients and allocate resources who need the most, especially in a resource limited center. Keywords: pancreatitis, alcohol, APACHE II, ICU, CTSI, contrast enhanced CT, surgery, mortality.

A 50-year-old female presented with xerostomia, recurrent oral ulcers, bilateral ocular dryness, and right submandibular swelling persisting for three months. Ultrasonography revealed an enlarged, heterogenous submandibular gland with increased vascularity, consistent with sialadenitis. Ophthalmic evaluation demonstrated markedly reduced Schirmer’s test results (4 mm bilaterally). Fine-needle aspiration cytology (FNAC) of the submandibular gland showed polymorphous lymphoid infiltrates (mature lymphocytes, centrocytes, centroblasts) and epithelial cells, excluding mycobacterial infection (AFB-negative, CBNAAT-negative). Serum antinuclear antibody (ANA) testing showed 3+ positivity at 1:80 dilution with a speckled pattern and an endpoint titre of 1:320. Lingual biopsy confirmed Sjögren’s syndrome (SS) with a focus score >1. Subsequent rheumatological evaluation revealed elevated rheumatoid factor (RF) and polyarthralgia, prompting a dual diagnosis of SS and rheumatoid arthritis (RA). Hematological and metabolic parameters (CBC, LFT, KFT, electrolytes, vitamin D, thyroid function) remained normal. This case highlights the diagnostic complexity of overlapping autoimmune syndromes, emphasizing the role of histopathology (focus score) and serology (ANA, RF) in differentiating primary Sjögren's Syndrome (SS) from secondary RA-associated SS. The rapid progression from glandular to systemic manifestations underscores the need for vigilant monitoring in SS patients for evolving rheumatological conditions. Multidisciplinary management involving ENT, ophthalmology, pathology, and rheumatology was critical to achieving diagnostic clarity and initiating immunomodulatory therapy. Keywords: Sjögren syndrome, xerostomia, keratoconjunctivitis sicca, autoimmune disease, rheumatoid arthritis, ANA, submandibular swelling.

Background: Until 2020, it was standard practice at our university-affiliated pediatric hospital to admit children with uncomplicated appendicitis for postoperative overnight observation. Growing evidence has indicated that same-day discharge following open appendectomy may be both safe and practical. We conducted a prospective study to compare outcomes, including complications and costs, between same-day discharge and overnight observation for such cases. Materials and Methods: Data were collected for pediatric patients who underwent open or laparoscopic appendectomies for uncomplicated appendicitis during 2020. Key variables included demographic information, admission and discharge timings, complications, readmissions, and costs. Statistical tools such as chi-square and multivariate regression were utilized for analysis. Results: Among 500 patients, 300 underwent same-day discharge, while 200stayed overnight for observation. No significant differences were noted in readmission rates, emergency visits, surgical site infections, or unscheduled clinic visits between the two groups. However, median costs were significantly lower for the same-day discharge group. Conclusion: The study demonstrates that same-day discharge for pediatric patients undergoing uncomplicated appendectomy is both safe and cost-effective, supporting its adoption as the standard of care. Keywords: Same-day discharge; OPEN/LAP appendectomy; pediatric; ambulatory surgical procedure; appendicitis.

Background: Acute appendicitis (AA) is a common cause of abdominal surgical emergencies, with a lifetime incidence rate of nearly 1 in 7 cases globally (1). Delayed diagnosis is related to a high incidence of morbidity and mortality. The objective is to compare the efficacy of Tzanakis and Alvarado scoring system in diagnosing acute appendicitis. Materials and Methods: This Prospective comparative observational study was conducted from October 2022 to October 2023 at SDM College of Medical Sciences and Hospital. It included 85 patients who was underwent open/laparoscopic appendectomy with the diagnosis of acute appendicitis. At admission, both Alvarado score and Tzanakis score was given. The final diagnosis was made based on histopathological report. Results: The sensitivity & specificity of the Alvarado Score was 23.06% & 58.33% respectively with a PPV of 38.45% & NPV of 44.09% with a p-value of 0.265. With a PPV of 84.82% and an NPV of 92.41%, the Tzanakis “score's sensitivity and specificity were, respectively, 93.15% and 83.33%. With a p-value less than 0.001, the diagnostic accuracy of the Tzanakis score was 91.7% The sensitivity of USG is 91.78%, and its specificity is 75.0% with a diagnostic accuracy of 89.41%. Conclusion: According to this study, the Tzanakis scoring system is a useful tool for the diagnosis of acute appendicitis. Keywords: Tzanakis Score, Alvarado Score, Diagnosis of Acute Appendicitis

Background: Aim: To assess the correlation between epicardial fat thickness and severity of coronary artery disease. Materials and Methods: This Cross sectional study was conducted with 100 Patients who underwent coronary angiogram in Dr. PSIMS & RF hospital for various indications during the study period from October 2018 - September 2020, fulfilling the inclusion and exclusion criteria. Results: correlation between epicardial fat thickness and severity of coronary artery disease was assessed and results were tabulated. Conclusion: Epicardial adipose tissue thickness was found to be increasing with increasing Gensini score. This shows that the thickness corresponds with the severity of coronary artery disease. It can be considered as an independent variable that can predict the risk of coronary artery disease apart from smoking, alcohol, dyslipidemias and obesity. Keywords: Coronary artery disease, Mortalty, ECG, CAD, Epicardial fat.

Background: Teaching about the effects of the use of tobacco and its related diseases is essential for undergraduate medical students, especially to counter the deadly effects of the same. Physicians occupy a key position in this regard, as they are uniquely placed to lead smoking cessation programs in the community. In most developed countries where tobacco use has decreased, doctors often have set an example by being the first group to quit tobacco use. Objectives: To evaluate knowledge regarding the health effects of tobacco use and also to study their attitudes and practice towards tobacco use and cessation. Materials and Methods: The present Descriptive cross-sectional study was carried out at Department of Community Medicine at CIMS, Chikkamagaluru involving first MBBS students of the 2024 batch at CIMS, Chikkamagaluru. Results: The mean age of the study population was 9.46±0.8 years. Gender wise distribution showed that 54% were males and 46% were females. Distribution according to knowledge of tobacco use revealed that 96.4% were having the knowledge about smoking as leading cause of lung cancer. 96.4% were aware that Smoking is a risk factor for coronary heart disease. 89.2% Knew about the harmful chemicals in tobacco smoke. 85.6% were aware of the dangers of smokeless tobacco. 54.7% opined that smoking cessation is possible. 3.6% told that they received formal training on smoking cessation. Conclusion: Prevalence of smoking in our study was 3.6%. Prevalence of second-hand smoke (passive smoking) at home was 10.1%. 96.4% were having the knowledge about smoking as leading cause of lung cancer. 96.4% were aware that Smoking is a risk factor for coronary heart disease. Majority had positive attitude towards quitting of tobacco. Keywords: Prevalence, tobacco, smoking, knowledge, practice.

Background: Stuttering is a multifactorial disorder involving both physiological and psychosocial components and formed by both biological and social constructs. Stuttering-related experiences frequently involve affective, behavioural, and cognitive responses, affecting daily activities and overall quality of life. When fluency is emphasized over content, stuttering can significantly impact an individual’s ability to engage in education, employment, relationships, and social life. This study aims to explore how social and attitudinal environments influence participation in various life domains among adolescents and young adults who stutter. Specifically, it examines factors affecting communication, interpersonal relationships, education, employment, community participation, and personal identity. By adopting a holistic perspective, the research seeks to expand existing knowledge on subjective psychosocial dimensions of stuttering, ultimately contributing to more effective therapeutic approaches. Materials and Methods: This study employed a qualitative descriptive research design with purposive sampling technique including adolescents and young adult participants aged 14 and older with diagnosis of Stuttering and competent in primary skills of English. Data was collected through the International Classification of Functioning, Disabilities, and Health (ICF) Checklist (Version 2.1a, Clinician Form) to assess activity limitations, participation restrictions, and environmental influences affecting individuals who stutter. Results: Results aligning with the previous research highlight the dual influence of environmental factors—facilitators contribute to a sense of inclusion and reduced stuttering-related disruptions, while barriers significantly hinder social participation. Immediate family members and friends emerged as substantial facilitators, offering emotional support that mitigates the psychological burden of stuttering. Conversely, societal attitudes, norms, and institutional ideologies were reported as severe barriers, restricting individuals’ ability to engage in professional, educational, and social contexts. Conclusion: The findings of present study emphasize that conceptualizing the stuttering experiences on the sociocultural model is highly appropriate for viewing Stuttering as both a biological construct and a social construct and multifactorial in origin. It is, therefore, vital to incorporate into clinical practice, psychosocial dimensions of stuttering such as feelings and the significance of stuttering in the individual’s life. Furthermore, to enhance therapy outcomes for the person who stutters, speech-language pathologists should constantly be aware of the influences of stuttering on the individual’s life in terms of social and attitudinal environment like family relationships, problems experienced in the workplace and emotional needs. Keywords: Attitudinal environment, ICF, Stuttering, Sociocultural construct.

Background: Tuberculous pleural effusion remains a diagnostic challenge, especially in high-burden settings like India. While adenosine deaminase (ADA) is widely used, its specificity is limited. Cartridge-Based Nucleic Acid Amplification Test (CBNAAT/GeneXpert) offers high specificity for tuberculosis (TB) detection, but its sensitivity in pleural fluid is variable. This study aimed to evaluate the diagnostic utility of CBNAAT in pleural effusion and compare it with ADA levels. Materials and Methods: A retrospective, observational study was conducted at a tertiary care center over two years, including 235 patients with pleural effusion. Clinical, radiological, and biochemical profiles were recorded. Pleural fluid was analyzed for ADA levels and subjected to CBNAAT. Final diagnoses were categorized into tuberculous, malignant, and other causes. Statistical analyses included sensitivity calculation, chi-square testing, and Cohen’s kappa for concordance. Results: Out of 235 patients, 164 were diagnosed with tuberculous pleural effusion and 11 with malignancy. CBNAAT detected TB in only 36 patients, yielding a sensitivity of 21.95%, though with high specificity. ADA >40 IU/L was observed in a majority of TB cases. CBNAAT positivity was significantly associated with elevated ADA levels (p < 0.001). All malignant effusions occurred in patients over 40 years of age, whereas 55% of TB cases occurred in those aged ≤40. Concordance between ADA and CBNAAT was low (kappa = 0.22), highlighting their complementary roles. Conclusion: While CBNAAT offers high specificity, its limited sensitivity restricts its use as a standalone diagnostic tool for pleural TB. ADA remains useful for screening, especially in younger patients. Combining ADA with CBNAAT improves diagnostic yield and is recommended in cases with high clinical suspicion and ADA >40 IU/L. Keywords: Tuberculous pleural effusion, CBNAAT, GeneXpert, ADA, pleural fluid, diagnostic accuracy, sensitivity, specificity.

Background: Postoperative sore throat (POST) is a common complication after endotracheal intubation under general anaesthesia, impacting patient comfort and recovery. Effective pharmacologic interventions are needed to minimize this morbidity. Objectives: To compare the efficacy of intravenous dexamethasone and intravenous magnesium sulphate in preventing POST and associated symptoms. Materials and Methods: This prospective, randomized study included 92 patients (aged 18–60 years, ASA I–II) undergoing elective surgery under general anaesthesia. Patients were divided into two equal groups receiving either IV dexamethasone or IV magnesium sulphate. POST, hoarseness, cough, hemodynamic parameters, and side effects were assessed at multiple postoperative intervals. Results: Magnesium sulphate showed significantly better outcomes at 2, 4, and 8 hours (p < 0.05) for POST reduction. Both agents were hemodynamically stable and well tolerated. Conclusion: Magnesium sulphate is more effective in early POST prevention, while both drugs remain safe and suitable for clinical use. Keywords: Postoperative sore throat; dexamethasone; magnesium sulphate; endotracheal intubation; anaesthesia complications; randomized controlled trial.

Background: Klippel-Trenaunay Syndrome (KTS) is an uncommon congenital vascular disorder characterized by capillary malformations, venous anomalies, and limb overgrowth. Anemia resulting from chronic bleeding secondary to vascular malformations is an unusual and underreported complication, particularly in pediatric cases. Clinical Description: We present the case of a 4-year-old male with KTS who developed recurrent severe anemia due to bleeding from vascular lesions. The child exhibited macrocephaly, dolichocephaly, pectus carinatum, and bilateral lower limb hypertrophy. Hemoglobin levels dropped as low as 2.3 gm/dL, necessitating multiple transfusions. Management: Magnetic Resonance Imaging (MRI) revealed extensive lymphovenous malformations in the pelvis and lower limbs. The patient received blood transfusions and symptomatic care, followed by referral to a multidisciplinary team for surgical evaluation. He was discharged with stable hemoglobin and advised regular follow-up. Conclusion: This case highlights the importance of recognizing chronic bleeding and severe anemia as potential complications in KTS, warranting early imaging and coordinated multidisciplinary management. Keywords: Klippel-Trenaunay Syndrome, severe anemia, pediatric vascular malformations, multidisciplinary management.

Background: Spinal anesthesia is commonly used in gynecological and lower abdominal surgeries. However, it can have a limited duration, and adjuvants are sometimes needed to extend analgesia. The most popular adjuvant is dexmedetomidine, a selective alpha-2 adrenergic receptor agonist. It also has minor antidepressant, sedative, analgesic, and sympatholytic effects. This study was designed to evaluate the efficacy of dexmedetomidine as an adjuvant at the dose of (0.5 µg/kg) for spinal anesthesia. Materials and Methods: This prospective randomized controlled study included 60 patients scheduled for abdominal or vaginal hysterectomy under spinal anesthesia. There was random allocation of cases to group A (n=30) and group B (n=30). Group A received intravenous dexmedetomidine (0.5 ug/kg over 10 minutes) group B received normal saline, and hemodynamic parameters, sensory and motor block characteristics, sedation scores, and adverse effects were assessed and compared between groups A and B. Results: The baseline demographic profile distributions were similar across both groups. Dexmedetomidine significantly reduced heart rate and mean arterial pressure at various intervals (p<0.001) because of its sympatholytic effects. Sensory and motor block durations were significantly longer in the dexmedetomidine group A as compared to group B (255.2 ± 8.6 min vs. 210.8 ± 33.1 min and 243.6 ± 17.0 min vs. 211.2 ± 16.7 min, respectively; p<0.001). Two-dermatome regression time was prolonged in group A. At 160 minutes, 86.7% of the dexmedetomidine group maintained Bromage Grade 3, with 100% retaining a sensory level at or above T8. Sedation scores were significantly higher without respiratory depression. Conclusion: Intravenous dexmedetomidine at 0.5 µg/kg significantly prolongs spinal anesthesia, enhances sedation, and maintains hemodynamic stability with minimal adverse effects. It is a valuable adjuvant for improving intraoperative and postoperative outcomes in spinal anesthesia for gynecological surgeries. Keywords: Spinal Anesthesia, Adjuvant, Abdominal Surgeries, Dexmedetomidine.

Background: Anemia during pregnancy is a major public health issue in India, contributing to adverse maternal and perinatal outcomes. This study aimed to determine the prevalence of anemia and its associated demographic, reproductive, and nutritional factors among pregnant women in rural Bareilly. Materials and Methods: A cross-sectional study was conducted among 385 pregnant women attending their first antenatal visit at a secondary care center. Hemoglobin estimation was done using the WHO color scale. Data were collected via a semi-structured questionnaire and analyzed using SPSS version 26. The chi-square test was applied to examine associations. Results: Anemia was observed in 66.75% of participants, with moderate anemia being most common. Higher prevalence was noted among rural women (71.53%) and those in three-generation families (75.65%). Anemia increased with gestational age. Meal frequency showed a strong association (p < 0.00001), with the highest prevalence among women consuming one meal daily. No significant associations were found with IFA supplementation or abortion history. Conclusion: Anemia in pregnancy is influenced by nutritional and demographic factors, highlighting the need for improved dietary practices and antenatal education. Keywords: Anemia in pregnancy, Pregnant women, Nutritional factors, Iron supplementation, Maternal health, Antenatal care.

Background: Diabetes and Tuberculosis are two major prevalent public health challenges in terms of morbidity and mortality in India. Systematic review has shown that, people with diabetes are 2.3times more risk for developing active TB disease compared to people without diabetes. Tuberculosis Infection (TBI) is a condition with persistent immune response to Mycobacterium tuberculosis antigen without any clinical symptoms of active TB disease. Individuals with TBI has 5-10% risk of developing active TB disease. The study was conducted with an objective to estimate the prevalence of TBI among diabetics and the factors associated with it. Materials and Methods: A cross-sectional study was conducted among the 323 diabetics attending outpatient department of tertiary care hospital in central Karnataka, India. Blood samples of the study participants were tested for TBI with Interferon gamma release assay (IGRA) test. Results: The prevalence of TBI among diabetics was 14.2% (95% CI: 10.6% to 18.5%). TBI did not had any gender or age predominance. People with uncontrolled diabetes had 2.54 (95% CI: 1.11-5.77) times risk of TBI then people with controlled diabetes and this finding was statistically significant. Conclusion: It is important to diagnose and treat TBI among diabetics, as they are at the risk of developing active TB disease. These findings will guide the policy makers in achieving the TB elimination goal in India. Keywords: Tuberculosis infection, Diabetics, Interferon gamma release assay, Tuberculosis elimination.

Background: Hamstring tightness is a common musculoskeletal issue that can reduce flexibility, limit knee range of motion (ROM), and predispose individuals to injury. Muscle Energy Technique (MET) is a manual therapy intervention aimed at improving muscle length and flexibility. Aim: To evaluate the effectiveness of Muscle Energy Technique (MET) on hamstring muscle length and knee ROM in females aged 25 to 50 years. Materials and Methods: An experimental, interventional, comparative study with a pre-test and post-test design was conducted on 90 female participants with clinically diagnosed hamstring tightness. Participants were randomly allocated into two groups: Group A received MET, while Group B underwent conventional treatment comprising moist heat application and static stretching. Hamstring flexibility was assessed using the Active Knee Extension (AKE) Test, and data were analyzed using paired and unpaired t-tests with significance set at p < 0.05. Results: Both groups showed significant within-group improvements in hamstring flexibility and knee ROM (p < 0.001). Group A's mean muscle length reduced from 27.40 ± 3.27 to 26.26 ± 2.93 units, and Group B from 28.11 ± 2.98 to 25.68 ± 2.96 units. AKE test scores improved significantly in both groups, with Group A increasing from 47.33 ± 6.80 to 54.56 ± 7.42 units and Group B from 48.47 ± 10.42 to 66.04 ± 10.15 units. Intergroup comparison revealed a statistically significant difference in AKE Test scores favoring Group B (p < 0.001). Conclusion: Both MET and conventional interventions effectively improved hamstring flexibility and knee ROM. However, MET demonstrated superior functional outcomes, highlighting its potential as a preferred intervention for managing hamstring tightness in females aged 25 to 50 years. Keywords: Muscle Energy Technique, Hamstring Tightness, Knee ROM, Flexibility, Active Knee Extension Test.

Background: Hamstring tightness is a common musculoskeletal issue that can lead to reduced strength, flexibility, and impaired quality of life, particularly among females. Muscle Energy Technique (MET) is frequently used to enhance flexibility and muscle performance; however, its impact on quality of life remains unclear. The aim is to evaluate the role of Muscle Energy Technique in improving hamstring muscle strength and quality of life among females with hamstring tightness. Materials and Methods: A total of 90 female college students aged 25 to 50 years with clinically diagnosed hamstring tightness were randomly assigned to two groups. Group A (n=45) received MET, while Group B (n=45) received conventional physiotherapy consisting of moist heat application and passive stretching. Hamstring flexibility was assessed using the Active Knee Extension Test (AKET), muscle strength through standard strength testing, and quality of life using validated questionnaires. The intervention lasted four weeks, and pre- and post-test comparisons were analyzed statistically. Results: Group A demonstrated a significant improvement in muscle strength post-intervention (p=0.012) compared to Group B. However, changes in quality of life within and between groups were minimal and not statistically significant (p=0.978). Flexibility (AKET scores) improved significantly in both groups, with Group B showing greater gains (p<0.001). Conclusion: Muscle Energy Technique significantly improved hamstring strength; however, neither MET nor conventional interventions produced meaningful short-term improvements in quality of life. This suggests that isolated muscle-focused interventions may not be sufficient to enhance overall well-being, highlighting the need for long-term, comprehensive rehabilitation approaches. Keywords: Muscle Energy Technique, Hamstring Tightness, Muscle Strength, Quality of Life, Flexibility.

Background: Human Immunodeficiency Virus (HIV) compromises the immune system, predisposing affected individuals to opportunistic infections, particularly of the lower respiratory tract. Respiratory infections significantly contribute to the morbidity and mortality among HIV-positive patients, especially in those with declining CD4 cell counts. Present study was conducted to evaluate the prevalence of lower respiratory infections among HIV-positive individuals and their association with immune status (CD4 count) in a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted on 100 HIV-positive adult inpatients at Rajindra Hospital, Patiala. Patients were evaluated clinically and through laboratory investigations including CD4 count, sputum microscopy, CBNAAT, culture, and radiological imaging. Statistical analysis assessed correlations between CD4 count and specific respiratory infections. Results: Tuberculosis was the most common LRTI (64%), followed by bacterial pneumonia (30%) and Pneumocystis jirovecii pneumonia (6%). Bacterial pneumonia predominated in patients with CD4 >200 cells/µL, while PJP occurred mostly in those with CD4 <50 cells/µL. A significant inverse relationship was observed between the number of presenting complaints and CD4 count (p<0.001). Conclusion: Tuberculosis and bacterial pneumonia are the leading respiratory infections in HIV patients. The risk and severity of infections correlate strongly with declining CD4 counts. Early evaluation and management of respiratory symptoms are essential for improving outcomes in HIV-infected individuals. Keywords: HIV, CD4 Count, Tuberculosis, Bacterial Pneumonia.

Background: The aim is to estimate the prevalence of chronic kidney disease (CKD) among adults residing in selected villages in Chengalpattu district, Tamil Nadu. To determine the association between socio-demographic characteristics (such as age, gender, education, occupation, marital status, and income) and the presence of CKD among the study participants. Materials and Methods: This cross-sectional study was conducted in a rural field practice area from October 2021 to March 2022. Male and female residents of the selected hamlet who were at least 18 years old were included in the study. Participants were eligible for inclusion if they were available during the data collection period and provided written informed consent. A pretested semi-structured questionnaire was used to collect data. Results: This study included 400 participants aged ≥ 18 years. The population under study had an average age of 47.8 ± 16.6 years. There were 263 (65.8%) female and 137 (34.2%) male participants. Compared with patients without CKD (45.4±16.3 years), those with CKD had a considerably higher mean age (60.8±11.9 years) (p<0.001). Compared to female patients (9.9%), male patients were more likely to receive a CKD diagnosis (27.0%) (p<0.001). There was a statistically significant relationship between CKD and lower educational attainment (P =0.02). The frequency of chronic kidney disease (CKD) was also found to be considerably greater among married patients, those with monthly incomes under ₹5,000, and those from unskilled occupational groups. Conclusion: A significant association was found between CKD and several important factors. Targeting these risk factors will help reduce disease and death because many lifestyle factors are related to them. By raising awareness through IEC activities, CKD can be controlled, and its complications can be reduced. Keywords: Lifestyle and behavioral factors, risk factors, non-communicable diseases, rural health, chronic kidney disease.

Background: Contact dermatitis is an inflammatory reaction of the skin caused by exogenous irritants acting on the skin. Despite Industrial advancement and particular attention to patient safety, contact dermatitis is one of the common occupational diseases with a large socio-economic impact. People living in developing countries are still in the habit of sitting in a cross- legged position on various surfaces. Cases details: This is a report of a case series of three rare cases of cross- legged sitting pattern of distribution of contact dermatitis from a tertiary care hospital of North India. The mean age of the patients was 54.27 years. Occupationally, a corporate employee, a street vendor and a school teacher were affected. All patients presented with chronic recurrent pruritic plaques on the feet with a mean duration of 4 years. Despite symptomatic relief with topical Steroids and oral Antihistamines, the condition recurred persistently. Patch testing revealed sensitivity to rubber mix; but the source of exposure remained unclear until photographic surveillance identified regular contact with a rubber surface sitting in a cross legged position. Conclusion: This case series highlights the importance of occupational history, environmental context and active patient caregiver engagement in identifying elusive allergens in chronic recurrent dermatosis. It also underscores a key patient safety principle: persistent, unexplained dermatologic conditions should prompt deeper investigation particularly photography to avoid misdiagnosis, prolonged morbidity and unnecessary cycles of treatment. Keywords: Allergic contact dermatitis, Rubber allergy, Photographic surveillance, Cross legged sitting, Rubber mat.

Background: Diabetes mellitus is a chronic non-communicable disease frequently associated with psychological comorbidities such as depression and anxiety, which often remain undiagnosed in primary healthcare settings. Timely detection and management of these comorbidities are essential for improving overall treatment adherence and quality of life in diabetic patients. The objective is to estimate the prevalence of depression and anxiety among patients with Type 2 Diabetes Mellitus (T2DM) attending primary health centers and to identify key sociodemographic, clinical, and behavioral predictors associated with these psychological conditions. Materials and Methods: A cross-sectional study was conducted among 400 adult patients with T2DM attending four purposively selected Primary Health Centers (PHCs). Data were collected using a pretested semi-structured questionnaire covering sociodemographic details, clinical history, lifestyle factors, and standard psychological scales—PHQ-9 for depression and GAD-7 for anxiety. Statistical analysis included descriptive statistics, chi-square tests for bivariate associations, and multivariate logistic regression to identify adjusted odds ratios (AORs) for predictors of depression. Results: The prevalence of depression (PHQ-9 score ≥10) was 41.5%, while anxiety (GAD-7 score ≥10) was reported in 37.3% of participants. No statistically significant association was observed between depression and gender, age, educational status, socioeconomic class, glycemic control, diabetic complications, or physical activity. However, substance use was significantly associated with lower odds of depression in multivariate analysis (AOR: 0.618; 95% CI: 0.384–0.996; p = 0.048). None of the other examined variables showed significant associations in the logistic regression model. Conclusion: There is a high burden of undiagnosed depression and anxiety among diabetic patients attending PHCs. The lack of consistent demographic or clinical predictors emphasizes the need for universal mental health screening in diabetic care, rather than selective targeting. Integrated care models that combine NCD and mental health services at the primary care level are urgently needed. Keywords: Type 2 Diabetes Mellitus, Depression, Anxiety, PHQ-9, GAD-7, Primary Health Center, Psychological comorbidity, Substance use, Mental health screening.

Background: Hepatitis is inflammation of the liver and can be caused by various viruses such as hepatitis A, B, C, D, and E. The present study was conducted to evaluate clinical profile of patients with HCV infection at a tertiary care hospital. Materials & Methods: The present prospective study was conducted on 150 patients diagnosed with HCV infection who received full course of anti HCV treatment in the form of direct acting antiviral drugs in the Medical Outpatient Department and ward of Department of Medicine of Government Medical College and Rajindra Hospital, Patiala. This study was carried out over a period of 1 year from March 2019 to February 2020. Patients were followed up at 4 and 8 weeks for clinical assessment, required investigations and to see side effects of direct acting antivirals. Results: Most common age group involved was age 41-50 years. 70% of patients were males. 66.7% of patients were of rural background. Most common symptom was fatigue. Intravenous drug use was the main risk factor. Most common clinical feature was fatigue in Non-cirrhotic patients, anorexia in compensated Cirrhosis and jaundice and abdominal distention in decompensated cirrhosis. Conclusion: The study concluded that the most common clinical presentation was asymptomatic (49.3%) followed by fatigue, anorexia, jaundice, abdominal distention, abdominal pain, and GI bleed. Key words: Hepatitis C, Fatigue, Cirrhosis.

Background: Cardiac arrhythmias are quite common in the setting of acute myocardial infarction. Ninety percent of patients with acute myocardial infarction (AMI) have some cardiac rhythm abnormality, and 25% have cardiac conduction disturbance within 24 hours of infarct onset. These are tachyarrhythmias, ventricular arrhythmias, and atrioventricular block. A good correlation exists between the site of infarct and type of arrhythmias. Sinus bradycardia, sinoatrial escape rhythms, Wenkebach type and complete heart block are usually associated with inferior wall myocardial infarction (IWMI). Atrial premature contraction (APC) and ventricular premature contraction (VPC) are usually seen in anterior wall myocardial infarction (AWMI). Materials and Methods: This observational study included 100 AMI patients over 2 years, diagnosed based on clinical signs, ECG changes, and elevated troponins or CK-MB. Patients were monitored for arrhythmias within 48 hours, and data were analyzed. Results: The result of this study of 100 AMI patients (68 males, 32 females) found the highest incidence in the 51–60 age group. Anteroseptal and lateral infarctions were most common (24% each), and 80% of arrhythmias occurred within the first 12 hours—primarily sinus tachycardia (24%) and bradycardia (20%) Conclusion: This study conclude that arrhythmias commonly occur early in AMI, often within the first hour, with sinus tachycardia and bradycardia being most frequent. Continuous early cardiac monitoring is crucial, especially in males aged 51–60 and those with anterior infarctions, to promptly detect and manage life-threatening arrhythmias. Keywords: Myocardial infarction, Arrhythmias, Bradycardia, Tachycardia

Background: Multidrug-resistant tuberculosis (MDR-TB) remains a significant global public health challenge, with India bearing a high burden of cases. In response, shorter all-oral regimens have been introduced to improve treatment outcomes and adherence. However, the efficacy and safety profile of these regimens require thorough evaluation. The objective is to assess the efficacy of the shorter oral regimen in MDR-TB patients and to evaluate the frequency, severity, and nature of adverse drug reactions (ADRs) associated with this regimen. Materials and Methods: This prospective observational study was conducted at the Department of Respiratory Medicine, over a period of 15 months. A total of 106 bacteriologically confirmed MDR-TB patients, diagnosed via CBNAAT and DST, were enrolled and treated with a standardized shorter oral MDR-TB regimen under the National Tuberculosis Elimination Program (NTEP). Data on demographic characteristics, clinical outcomes, ADRs, and drug resistance patterns were collected and analyzed. Results: Among the 106 patients, 66.5% were male and the mean age was 42.4 years. The majority (89.6%) had pulmonary TB. ADRs were observed in 81.1% of patients, with gastrointestinal upset (73.2%) being the most common. Other ADRs included hepatic toxicity (17.4%), arthralgia (8.1%), and psychiatric symptoms (3.5%). Most ADRs were mild (76.7%) and manageable. Treatment outcomes showed a high success rate, with a majority of patients either cured or having completed treatment successfully. A small proportion experienced treatment failure, death, or were lost to follow-up. Conclusion: The shorter oral regimen for MDR-TB demonstrated good efficacy with an acceptable safety profile. Most adverse reactions were mild and manageable, supporting the continued use of this regimen under close monitoring. Timely identification and management of ADRs are crucial for treatment success and patient adherence. Keywords: Multidrug-resistant tuberculosis (MDR-TB), Adverse drug reaction, Shorter oral regimen

Background: In India, under-five child malnutrition is still a serious public health issue, particularly in rural areas where there is a high prevalence of poverty, poor dietary habits, and insufficient health facilities. The aim of the current study was to determine the prevalence of malnutrition and sociodemographic profile of study subjects in rural District Jalaun, Uttar Pradesh. Materials and Methods: In a community-based cross-sectional study that took place between June 2023 and November 2024, 370 children between the ages of 0 and 5 were chosen using multistage random sampling. Anthropometric measurements in accordance with WHO guidelines and a pre-tested semi-structured questionnaire were used to gather data. WHO Z-scores and the Composite Index of Anthropometric Failure (CIAF) were used to evaluate nutritional status. Results: The findings showed that 40.54% of the 370 children were stunted, 34.05% were underweight, 17.57% were wasted, and 0.54% were overweight. 54.3% of children experienced one or more types of malnutrition, according to the CIAF. The most prevalent types were stunting alone (16.8%) and stunting plus underweight (15.4%). According to a sociodemographic analysis, the majority of children (47.84%) came from joint families, had a low socioeconomic status (52.16% in the upper lower class), and 38.1% of their mothers were illiterate. The majority of maternal age at pregnancy (55.1%) were older than 24 years. Conclusion: In rural Jalaun, malnutrition is still very common among children under five. In order to address the complex causes of childhood malnutrition, the results highlight the necessity of community-based nutritional interventions, maternal education, and enhanced socioeconomic support. Keywords: Malnutrition, Underweight, Stunting, Wasting, Under-five children, Socio-demographic factors, Rural India

Background: Traumatic brain injury (TBI) has been a leading cause of death, morbidity and disability all over the world. Various serum markers have been studied to establish a correlation to the outcome of TBI patients like IL-6, serum albumin, pre-albumin levels, S-100 B protein and other glial markers. Materials and Methods: A retrospective study was conducted on 110 patients admitted to Dayanand Medical College and Hospital, Ludhiana, from 2018 to 2019. The participants were patients with severe traumatic brain injury. Serum albumin levels were measured on admission (Day 1) and patient’s outcome was determined at the time of discharge using the Glasgow Outcome Score (GOS). Serum albumin levels at admission were correlated with the duration of hospital stay, total stay in intensive care unit (ICU) and length of ventilator support required. Complications, if any were noted. Results: 78 out of 110 patients had an unfavourable outcome; of which 78.2% had hypoalbuminemia and 21.8% had normal albumin levels at the time of admission. Among 32 patients with a favourable outcome, 75% had normal albumin levels, while 25% had hypoalbuminemia. Patients with hypoalbuminemia had a mean hospital stay of 17.03 ± 2.56 days, in contrast to patients with normal serum albumin levels who had a hospital stay of 14.10 ± 1.85 days. Hypoalbuminemia patients had a mean ICU stay of 6.94 ± 1.53 days as compared to patients with normal serum albumin levels who had a mean ICU stay of 5.56 ± 1.25 days. Mean duration of mechanical ventilation was 5.17 days in hypoalbuminemic patients and 4 days in patients with normal serum albumin. Complications were observed in 37.68% of patients with hypoalbuminemia, compared to 17.07% of those with normal serum albumin levels. Conclusion: The strong association between hypoalbuminemia and the increased need for surgical intervention in TBI patients suggests that serum albumin levels can serve as a valuable prognostic indicator in these cases. Keywords: Hypoalbuminemia Albumin, favourable, unfavourable, traumatic brain injury, Outcome, Intensive Care Unit.

Background: Cervical cancer remains one of the leading causes of cancer-related morbidity and mortality among women, particularly in low- and middle-income countries. Human papillomavirus (HPV) infection is a major etiological factor, and its prevention through vaccination and screening is critical. Objective: This study aimed to assess the knowledge, attitude, and practice (KAP) regarding cervical cancer and HPV vaccination among mothers of school-aged children. Materials and Methods: A cross-sectional descriptive study was conducted among 385 female participants. Data were collected using a structured, pre-tested questionnaire covering socio-demographic details, knowledge about cervical cancer and HPV, attitudes toward screening and vaccination, and current preventive practices. Results: Out of 385 participants, 77.9% were aware of cervical cancer, yet detailed knowledge regarding risk factors, symptoms, and screening methods was suboptimal. While 64.2% were aware of the availability of HPV vaccines, only 47.5% had received the vaccine themselves, and 45.3% had vaccinated their children. Attitudes were moderately positive, with over half of participants expressing willingness to undergo screening or vaccination, especially if provided free of cost. However, practical uptake of preventive services remained low. Conclusion: It is concluded that while attitudes toward cervical cancer prevention are favourable, there exists a significant gap in both knowledge and practice among mothers. Public health interventions focusing on education, school-based awareness programs, and improved vaccine accessibility are essential to enhance HPV vaccine uptake and cervical cancer screening. Keywords: Cervical cancer, HPV vaccination, knowledge-attitude-practice, screening, public health, awareness.

Background: Peritonitis is a life-threatening abdominal emergency with varied etiologies. This study evaluates the clinical profile, causes, surgical management, and post-operative outcomes of patients presenting with peritonitis. Materials and Methods: A prospective observational study was conducted from January 2024 to January 2025 at a tertiary care hospital. Data from 52 patients were collected via a structured proforma and analyzed using Microsoft Excel and Python. Variables included age, sex, clinical presentation, radiological findings, operative findings, surgical interventions, etiology, and outcomes. Results: The majority were males (84.6%), with a peak incidence in the 30-40 age group. The most common presentation was generalized abdominal pain (90.4%). Peptic ulcer perforation was the leading cause of peritonitis (67.3%), predominantly due to acid peptic disease (42.3%), chronic alcohol use (17.3%), and NSAID intake (11.5%). Other causes included typhoid ileal perforation, gangrenous gallbladder, small bowel gangrene, traumatic abdominal injury, and malignancy. Modified Graham’s patch repair was the most commonly performed procedure (73.1%). primary closure of perforation was done in few patients. Additional procedures were needed in few patients such as feeding jejunostomy, gastrojejunostomy with jejunojejunostomy, reverse tube jejunostomy, loop ileostomy, inguinal hernia repair, resection of Meckel’s diverticulum, extended left hemicolectomy or cholecystectomy. No obvious perforation was found in some patients due to either primary peritonitis or sealed off perforation. Post-operatively, 84.6% were discharged by day 6. Mortality was 9.6%, and re-exploration was required in 11.5%. Conclusion: Peptic ulcer disease remains the predominant cause of peritonitis in our setting. Prompt diagnosis, radiological confirmation, and surgical intervention and additional procedures such as Feeding jejunostomy, tube gastrostomyr or gastrojejunostomy in selected patients improve outcome. Ileal perforation due to typhoid or obstructive perforations are less common but need prompt diagnosis and management. Public awareness regarding NSAID use and alcohol-related complications is warranted. Keywords: Gastrointestinal perforation, Abdominal pain, Operative interventions, Outcome. Perforation peritonitis, Clinical study, Exploratory laparotomy.

In this study we compared the effect of propofol and sevoflurane on cognitive function and memory in the post-operative period and also the effect on postoperative recovery quality in patients undergoing general anaesthesia. Aim of the study is to compare the effects of propofol and sevoflurane on cognitive functions and memory in terms of psychometric test pre and post operatively. 90 patients of age group 18– 60 years and ASA grade I, II scheduled for elective open cholecystectomy under general anaesthesia were included the study. Patients were divided into two groups in induction and maintenance: group P: Inj. propofol and group S: sevoflurane. Assessment of cognitive function and memory of patients in both groups was done perioperatively by following Materials and Methods: MMSE score, CVLT, DST, RBMT and Recalling the names of surgeon and anaesthesiologist. Post operatively, patients were observed for recovery by alderate recovery score up to 60 minutes and assessed for pain by visual analogue scale up to 240 minutes postoperatively. Cognitive function and memory up to 240 minutes was assessed postoperatively. The recovery quality was better with sevoflurane than propofol up to 5 mins. Sevoflurane had less impact on cognitive function and memory as compared to propofol up to 30 mins postoperative. We concluded from the study that when rapid recovery of cognitive function and memory are desired, sevoflurane is more favourable than propofol. Keywords: Propofol, Sevoflurane, POCD.

Background: The aim is to compare the efficacy of plain ropivacaine and ropivacaine with dexmedetomidine in ultrasound guidance supraclavicular brachial plexus block scheduled for the upper limb orthopedic surgeries. Materials and Methods: It was a Double-blinded randomized controlled study carried out at Tertiary care teaching hospital. During the period from 18 months (DECEMBER 2022 TO JULY 2024). A minimum sample size of 66 was thus required to obtain valid results for the objectives of this study. To improve the validity of the study, we thus rounded off to a sample size of 70, i.e., 35 subjects per group. Results: The patients in group R received 29 ml 0f 0.5% Ropivacaine + 1 ml saline, and those in group RD received 9 ml of 0.5% Ropivacaine + 50 mcg (0.5 ml) of Dexmedetomidine with 0.5 ml saline. The mean age in group R was 35.63 + 6.0 years and the mean age in group RD was 35.57 + 5.94 years. The two groups were thus comparable as there was no statistically significant difference between the two study groups (p=0.986). Majority of the study subjects belonged to ASA category I (41, 58.57%) followed by ASA category II (29, 41.4%). In the present study, similar distribution was seen within the study groups, with no statistically significant difference (Chi2 p-value=0.224). The mean baseline heart rate of the study subjects was 81.21 + 7.51 beats/minute, mean baseline systolic blood pressure was 122.66 + 9.52 mm Hg, and mean baseline diastolic blood pressure was 78.69 + 7.56 mm Hg. The mean duration of motor block was found to be 478.76 + 2.04 minutes in group R, whereas it was 669.84 + 2.45 minutes in group RD. This difference was found to be statistically significant (p<0.001). The mean VAS scores at 6 hours, 10 hours, 14 hours and 24 hours postoperative periods were measured and compared. The subjects in group R were found to have higher mean VAS scores at any point of time, as compared to the subjects in group RD. The differences in mean VAS scores were found to be statistically significant. Conclusion: Dexmedetomidine when given as an adjuvant with ropivacaine as supraclavicular block; significantly shortens the time taken for onset of sensory and motor block. Prolongs the duration of sensory and motor block significantly enhances analgesia. The present study does not cause any significant complications. Keywords: Dexmedetomidine, Ropivacaine, supraclavicular block, Upper limb, Ultra sound guidance, VAS Score.

Background: Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness, primarily managed by lowering intraocular pressure with topical medications. This systematic review evaluates the effectiveness, safety, and tolerability of current medical treatments, including prostaglandin analogues, beta-blockers, alpha agonists, and carbonic anhydrase inhibitors. Materials and Methods: The present systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was carried out across major electronic databases to identify relevant analytical studies and full-text articles related to the treatment of glaucoma. The risk of bias in the included studies was assessed using standardized and validated methodological tools. Results: This systematic review included eight eligible studies after screening 691 records and excluding duplicates, irrelevant articles, and incomplete data. The studies varied in design and interventions but all focused on glaucoma treatment. Quality assessment was performed using RevMan and the Cochrane risk of bias tool. Among the included studies, 27.08% had a high risk, 35.42% had a low risk, and 37.50% had an unclear risk of bias in outcome assessor blinding. Overall, the included studies were of moderate to good quality, supporting the reliability of the review findings. Conclusion: Glaucoma treatment focuses on lowering intraocular pressure using eye drops. Success depends on patient adherence. Statins and some blood pressure medications may help, but their role is still unclear. Managing overall health and improving compliance are key to preventing vision loss. Keywords: Glaucoma, intraocular pressure, eye drops, medical management, patient compliance, statins, antihypertensives, vision loss prevention, ocular hypotensive drugs, treatment adherence.

Background: Hypertension and thyroid dysfunction are prevalent endocrine and cardiovascular conditions that often coexist, sharing complex physiological interrelationships. Thyroid hormones significantly influence vascular resistance, cardiac output, and lipid metabolism, potentially affecting blood pressure regulation. This study aimed to assess the prevalence of hypertension among individuals with thyroid dysfunction and identify associated demographic, lifestyle, and biochemical risk factors. Materials and Methods: A cross-sectional observational study was conducted involving 600 adult participants (aged 20–60 years) attending a tertiary care hospital. Participants were categorized based on thyroid status: euthyroid, hypothyroid, and hyperthyroid. Blood pressure was measured following standardized procedures. Thyroid function was assessed using serum TSH, free T3, and free T4 levels. Additional data on BMI, smoking, physical activity, and lipid profiles were collected. Statistical analysis included Chi-square tests, t-tests, and multivariate logistic regression. Results: Among the 600 participants, 34.7% (n=208) had thyroid dysfunction (27.5% hypothyroid, 7.2% hyperthyroid). The prevalence of hypertension was 48.6% in hypothyroid and 38.4% in hyperthyroid individuals, compared to 21.9% in euthyroid individuals (p < 0.001). Mean systolic blood pressure was highest in the hypothyroid group (136.2 ± 12.7 mmHg) followed by hyperthyroid (132.1 ± 11.9 mmHg) and euthyroid groups (124.8 ± 10.2 mmHg). Logistic regression revealed significant associations of hypertension with hypothyroidism (OR: 2.84, 95% CI: 1.92–4.21), obesity (OR: 3.17), sedentary lifestyle (OR: 2.48), and dyslipidemia (OR: 2.33), all p < 0.05. Conclusion: Thyroid dysfunction, especially hypothyroidism, is significantly associated with increased prevalence of hypertension. Identification and management of thyroid-related risk factors could play a pivotal role in hypertension prevention and control. Keywords: Hypertension, Thyroid dysfunction, Hypothyroidism, Hyperthyroidism, Risk factors, Prevalence.

Background: The aim is to evaluate the clinical outcomes, symptom relief, and complication profile associated with the use of microdebrider in turbinate reduction and endoscopic sinus surgery. Materials and Methods: A prospective observational study was conducted in the Department of Otorhinolaryngology at a tertiary care teaching hospital over a period of 12 months. 75 patients in each arm (n = 150)—one group treated with microdebrider assisted inferior turbinate reduction ± FESS (Group A) and the other with conventional instruments (Group B). Results: Showed that Group A experienced significantly better postoperative outcomes, including a 15-point improvement in NOSE scores—indicating faster and more noticeable relief of nasal congestion. The composite complication rate was markedly lower in Group A (14.7%) compared to Group B (38.7%), with crusting reduced from 20% to 5% (p = 0.007). Although reductions in repacking and synechiae were also observed in Group A, some did not reach statistical significance. Conclusion: The study concludes that microdebrider-assisted surgery is a safe, effective technique that enhances patient comfort, reduces complications, and leads to better overall surgical outcomes. Keywords: Microdebrider, Inferior turbinate reduction, Endoscopic sinus surgery, Nasal obstruction, Chronic rhinosinusitis, NOSE score.

Background: The aim of present study is to perform preimplantation uterine artery doppler and it`s correlation with perinatal and maternal outcomes. Materials and Methods: It was a prospective, observational study was carried out in the Department of gynecology, on the women coming for fertility treatment. The study was carried out for a period of 24 months was conducted on 50 patients. All pregnant women aging between 21 years and 35 years with single fetus for follow up were included. Results: The present study found that most participants were aged 26–30 years, with a mean age of 28.12 years, and 68% were primiparous. Centrally located placenta was observed in 60% of cases. Common pregnancy complications included gestational hypertension (12%), pre-eclampsia (8%), and HELLP syndrome (4%). Abnormal Doppler indices, particularly in uterine and umbilical arteries, were associated with adverse neonatal outcomes such as low birth weight (22%) and preterm birth (18%). The pulsatility and resistance indices were significantly higher in subjects with adverse outcomes. Right uterine artery PI and RI showed the highest sensitivity and negative predictive value. Umbilical artery PI demonstrated excellent specificity and positive predictive value. Conclusion: The study concludes that abnormal uterine and umbilical artery Doppler indices are significantly associated with adverse neonatal outcomes such as low birth weight, preterm birth, IUGR, and NICU admissions. Routine Doppler assessment, particularly of the uterine and umbilical arteries, can serve as an effective tool in predicting and managing high-risk pregnancies. Keywords: Neonatal Intensive Care Unit, Relative Risk, Intrauterine Growth Restriction, Pulsatility Index , Resistance Index.

Background: The aim is to study the various clinico-radiological profile of cerebro-vascular stroke and various risk factors of cerebrovascular accident in a tertiary care center. Materials and Methods: 100 patients enrolled in the study were subjected to a detailed clinical history and physical examination. Clinical history was obtained from the relatives when the patient is having speech disturbances, altered sensorium and loss of consciousness. An analytical approach was adopted to assess the risk factors, clinico-radiological profile and the outcome in patients with acute cerebrovascular disease. Results: It is evident from the results that majority of patients do not having any symptoms and those were recovered also. The data subjected to statistical chi squared test reveals the highly existence of statistically significant association between physical conditions and outcome in patients with acute cerebrovascular disease (p value: 0.002). Almost a higher percentage of patients were having left MCA and right MCA and thosw recovered partially. The data subjected to statistical chi squared test reveals the existence of statistically significant association between lesion in CT Vessel and outcome in patients with acute cerebrovascular disease (p value: 0.022). Conclusion: On the basis of our present study we can concluded that the elderly population is more commonly associated with stroke, with most common clinical features were hemiparesis, hemiplegia, vomiting, dizziness. CT being the most common radiological tool used for assessing the stroke patients. Almost a higher percentage of patients were having left MCA and right MCA and thosw recovered partially. Keywords: Computed Tomography, Disability Adjusted Life Years, Recombinant Tissue Plasminogen Activator, Transient Ischemic Attack.

Background: Drug-drug interactions (DDIs) are a significant cause of preventable adverse drug events, especially in settings where polypharmacy is common. This study aimed to assess the prevalence, pattern, and severity of potential DDIs in prescriptions of patients attending a tertiary care hospital. Objectives: To evaluate the frequency and severity of potential DDIs in outpatient prescriptions and to identify the most common interacting drug pairs. Materials and Methods: A cross-sectional observational study was conducted over a period of three months in the outpatient department of a tertiary care hospital. A total of 100 prescriptions were analyzed. The demographic details, number of drugs per prescription, and presence of potential DDIs were recorded. DDIs were classified based on severity into minor, moderate, or major categories. Statistical analysis was performed using chi-square test, and a p-value <0.05 was considered statistically significant. Results: Among the 100 prescriptions analyzed, 66% exhibited at least one potential DDI. The prevalence of minor, moderate, and major interactions was 22%, 28%, and 16% respectively. The mean number of drugs per prescription was 5.2 ± 2.1. A statistically significant association was found between polypharmacy (more than 6 drugs) and increased DDIs (p < 0.05). Patients over 50 years had a higher incidence of major interactions (p < 0.05). The most frequent interacting pairs included Aspirin + Clopidogrel and Metformin + Furosemide. Conclusion: Potential DDIs are common in prescriptions, particularly among elderly patients and those with polypharmacy. Rational prescribing and routine medication review are essential to minimize adverse outcomes. Keywords: Drug-drug interactions, Polypharmacy, Adverse drug events, Prescription analysis, Tertiary care hospital.

Background: Non-venereal dermatoses tend to be confused with sexually transmitted diseases, which may be responsible for considerable concern to the patients. This study was done to analyze clinical profile of non venereal diseases of genitalia. Materials and Methods: The study was conducted on 150 patients with genital lesions of 18-80 years age groups during the period of June to December 2024. The patient’s data was recorded in a pre-structured proforma that includes detailed clinical history, general and cutaneous examination. Data collected was analysed, tabulated, and conclusions were drawn. Results: Total of 150 cases were analysed during the study period of june to December 2024. Most of the cases belong to the age group 21 - 30 years (23.5%). Males were slightly more than females. Conclusion: Non-venereal genital dermatoses present a wide clinical spectrum and are more common in young males. Infections and infestations were the most prevalent, followed by inflammatory and benign conditions. Early recognition and accurate diagnosis are essential to avoid mislabeling as sexually transmitted infections and to reduce associated psychological distress. Keywords: Non venereal diseases of genitalia, SCC (squamous cell carcinoma).

Background: Infected necrotizing pancreatitis (INP) is a severe and life-threatening complication of acute pancreatitis (AP), associated with high morbidity and mortality. Early risk identification is critical for timely intervention and improved clinical outcomes. Materials and Methods: A prospective observational study was conducted including 52 patients diagnosed with acute pancreatitis. Patients were stratified into infective and sterile groups using clinical, radiological, and laboratory criteria. Data collected included physiological parameters, serum procalcitonin levels, and APACHE III scores, which were analyzed for their prognostic value Results: Patients in the infective group showed significantly higher serum procalcitonin levels and APACHE III scores compared to the sterile group. These findings underscore the utility of both markers in early risk stratification of INP. Conclusion: The study demonstrates that both the APACHE III scoring system and serum procalcitonin levels serve as effective predictors for the development of infected necrotizing pancreatitis. Their combined use could facilitate timely and targeted therapeutic interventions in patients with acute pancreatitis. Keywords: Acute pancreatitis, infected necrotizing pancreatitis, APACHE III score, procalcitonin, prognostic biomarkers, risk stratification.

Background: Oesophageal cancer represents a significant oncological burden in Northeast India, particularly in Lower Assam. This study aims to evaluate and compare survival outcomes between patients from Kamrup (Metropolitan) and other districts, providing insights into potential geographic disparities despite treatment at a common tertiary care centre. Materials and Methods: A retrospective cohort analysis was conducted using data from the Hospital-Based Cancer Registry at the State Cancer Institute, Guwahati, spanning 2018–2022. Kaplan–Meier survival analysis was applied to assess differences in survival patterns across eleven districts, grouped as Kamrup (Metropolitan) and ten other districts. Patients were stratified by treatment status, and log-rank tests were used to determine statistical significance. Results: Among the 879 oesophageal cancer patients analysed, the treated subgroup from outside Kamrup (Metro) showed significantly better survival outcomes than those from Kamrup (Metro) (log-rank p = 0.03). No statistically significant difference was observed in the untreated group (p = 0.73). The overall survival difference between the two district categories trended toward significance (p = 0.087), suggesting potential disparities in treatment-related outcomes. Conclusion: The study highlights that despite geographical proximity to a tertiary cancer centre, patients from Kamrup (Metropolitan) had poorer survival among those treated, indicating possible systemic or care-related disparities. These findings emphasise the need for contextual interventions, improved care pathways, and further research to address urban–rural inequities in cancer survival. Keywords: Oesophageal cancer, survival analysis, Lower Assam, geographic disparity, treatment outcome.

Background: Evaluation of Middle cerebral artery Pulsatility index values in gestational hypertensive patients. Materials and Methods: It is an Analytical study in Department of Radio diagnosis over a period of 6 months in 40 pregnant women in II and III rd trimester with gestational hypertension as high risk factor referred from Department of Obstetrics and Gynaecology to Department of Radiodiagnosis. Results: Abnormal MCA/UA PI (Cerebroplacental ratio) Doppler ratio strongly correlated with worse fetal prognosis. Fetuses with abnormal Doppler Velocimetry had a significantly higher incidence of low birth weight, and admission to NICU. Late onset FGR fetuses with normal Doppler Velocimetry on diagnosis show progression from 37 weeks gestation with worsening uteroplacental ratio followed by a decrease in MCA pulsating index (PI). Conclusion: Umbilical artery Doppler may be normal, but fetuses may react with decreased middle cerebral artery (MCA) impedance in response to hypoxemia. This leads to late development of complications in fetus and ultimately leads to perinatal mortality. Keywords: Pulsatility index, Resistive index, Cerebroplacental ratio, Neonatal intensive care unit.

Background: Trauma being major public health problem in all countries. In this study we evaluated 100 patients presenting to major trauma centre of Mumbai. We assessed pattern of injury, major organ involved, diagnostic tools and its management and outcome in blunt abdominal trauma cases. Materials and Methods: We evaluated all blunt abdominal trauma cases presented to our centre during period of two years. We assessed patients in terms of mechanism of injury, investigational tools used (FAST, CT, Xray), organ injured, approach of management whether conservative or surgical and outcome of patients including morbidity and mortality. Results: Study enrolled 100 patients suffering from blunt abdominal trauma. Most common cause was road traffic accident (64%) followed by fall from height (24%), hit by blunt objects (6%) and assault (6%). X ray was most common diagnostic tool used followed by FAST and CT scan. DPL was used occasionally. Spleen was most commonly injured organ (30%) followed by liver (18%), small bowel and mesentery. Most cases (56%) were managed conservatively whereas 44 (44%) cases were managed surgically. Splenectomy was the most common operative procedure done (13% of total patients). Wound infection was most common post operative complication which was present in 27.27% of operated cases. Mortality of 10% was reported in study and most common cause of death was septicaemia. Conclusion: This study investigated mechanism of injury, common organs involved, diagnostic tools and outcome of patients following blunt abdominal trauma in major trauma centre of Mumbai. Key words: Blunt abdominal trauma, diagnostic tools, outcome.

Background: Spinal anesthesia for caesarean delivery is the best anesthetic technique, as it is simple to perform with rapid onset of anesthesia, complete muscle relaxation, lower incidence of failed block, less drug doses, minimal neonatal depression and decreased incidence of aspiration pneumonitis are advantages of spinal anesthesia. The present study is to compare the efficacy and practicability of using the midazolam-bupivacaine mixture and bupivacaine intrathecally in patients undergoing elective caesarean delivery. Materials and Methods: The present study was conducted on 50 patients belonging to ASA grade I and II between 18 to 35 years of age who were scheduled for caesarean delivery in Govt. Medical College & Attached Hospitals, Dholpur, Rajasthan, India during the one-year period. The patients were randomly allocated into 2 groups of 25 each. Effectiveness of pain relief in the postoperative period was assessed by Visual Analogue Score. Results: The mean onset time for sensory blockade & maximum motor blockade was no statistical significance between the two groups. The duration of sensory blockade is increased from 90.5 minutes in group I to 116.4 minutes in group II and P value is < 0.001 which is highly significant. Here, the duration of analgesia has been increased considerably from 120.7 minutes in group I to 220.9 minutes in group II which is statistically highly significant with the p value being < 0.001. The visual analogue score for effectiveness of pain relief was no statistical significance between the two groups. Conclusion: Postoperative pain relief is a growing concern to an anaesthesiologist since no single analgesic is free from side effects. Moreover, intrathecally administered midazolam improves quality of anaesthesia during the spinal procedure. Keywords: Midazolam, Intrathecal, Sensory blockade, Motor blockade, VAS Score.

Background: Cerebro-Vascular Accident (CVA) or stroke, is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. It is a global health epidemic and a leading cause of disability and morbidity. Ischemic strokes are the most common types accounting for 80-85% of CVA. The crude prevalence of stroke in India is upto 560/ 100000 population. Materials and Methods: Relevant history with list of risk factors and comorbidities was made. Investigation included complete hemogram, C-Reactive Protein (CRP), Erythrocyte Sediment Rate(ESR). It is an observational cross-sectional study conducted in Department of General Medicine at Basaveshwar Teaching and General Hospital attached to Mahadevappa Rampure Medical College, Kalaburagi. Results: In 30 AIS patients (mean age 55.4 years), 60% were male. Hemiparesis was the most common complaint (33.3%). The mean hospital stay was 6.3 days. Diabetes (53.3%) and hypertension (46.7%) were the main risk factors, with 63.4% having a sedentary lifestyle. NIHSS scores showed significant correlations with neutrophils, ESR, CRP, NLR (P<0.01), and negative correlations with lymphocytes and platelets (P<0.05). NIHSS scores were also associated with diabetes, hypertension, and lifestyle (P<0.05). Conclusion: These acute phase reactants and simple ratios are inexpensive, simple and easy bedside measures to assess the severity of AIS with positive correlation to NIHSS and illuminates on prompt prophylactic measures to reduce the inflammation of blood vessels, in the long run can significantly reduce the incidence of stroke. Keywords: CVA, AIS, CRP.

Background: Agriculture and farming is the most common profession in India. With the modernization of this sector, new equipment is continuously being added for ease of farming. However, using this equipment without proper training and safety has led to a significant increase in farming-related injuries. This study aims to evaluate the injury patterns, severity, and outcomes of hand tiller-related extremity injuries in a rural tertiary care center over a five-year period. Materials and Methods: A retrospective review of records of 21 patients (25 limbs) presenting with hand tiller-related lower limb injuries between May 2019 and May 2024 was done. Data was collected for demographics, injury characteristics, Gustilo-Anderson classification, management, and outcomes. Descriptive statistics were used for analysis. Results: In this study of 21 trauma patients (age range 3–57 years; mean 31.3 years), the majority of our patients were young males (90.5%). Lower limb injuries were most common, involving 18 patients (85.7%), while upper limb injuries were found in 3 patients (14.3%). Fractures of both bones of the leg accounted for 14 cases, with 11 being open fractures (6 classified as Gustilo-Anderson grade 3). Interlocking nailing was the most common procedure (10 cases), followed by external fixation and amputation. Four patients underwent amputation due to severe Grade 3c injuries. We faced complications which included 2 non-unions, 2 deep wound site infections, 1 hardware-related issue and 2 delayed wound healings. Conclusion: Hand tiller injuries result in severe open fractures or amputations in young male population. These injuries have higher rates of infection, neurovascular compromise and amputation. They represent a significant and preventable healthcare burden. Urgent implementation of preventive strategies, including farmer education, mandatory safety equipment and legislative guidelines is crucial to prevent these injuries in rural areas. Keywords: Hand tiller injuries, agricultural injuries, open fractures, amputation, rural orthopedics.

Background: Tumor lysis syndrome (TLS) is a critical medical condition which arises from the rapid breakdown of tumor cells, leading to significant metabolic disturbances like hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia. These disturbances can result in severe complications, even death. TLS is most common in hematological malignancies with an incidence as high as 42%. However in solid tumor, its prevalence is only 10% with high mortality rate (about 45%). Thus, timely diagnosis and treatment initiation are of paramount importance. In cases of solid tumors, patients who present with laboratory TLS (LTLS) have the median age of presentation of 58 years. Also, the most common solid tumors prone to developing TLS are hepatocellular carcinomas, lung cancer, melanoma, breast cancer followed by prostate and colon cancers. So the presentation of TLS in prostate cancer in young patients of age 40 and 37 years is unique in our case report. TLS has no specific biomarker and point of care testing (POCT) for diagnosis, thus depends only on correlation of laboratory reports and clinical findings. Here, we describe two cases of 40 year and 37 year old male patients with critically high serum potassium and phosphorus where it was found that the samples had no pre-analytical, analytical and post analytical errors. Through our two cases we have tried to elicit the challenges faced by doctors in standalone laboratories in detecting TLS by only analysing biochemical and hematological parameters in the sample and we have tried to come up with a protocol that may bridge the gap between clinicians and lab medicine professionals. This can be helpful in early correlation, diagnosis and treatment of the patients. Materials and Methods: 2 cases of early onset prostate cancer patients (40 year old and 37 year old respectively) were considered in this case series. Both had critically high serum potassium and phosphorus values on initial investigation. Results: After taking complete history of the patients and after ruling out pre-analytical, analytical and post analytical errors in the samples, they were diagnosed with Tumour Lysis Syndrome and were immediately started on treatment. Both patients survived and were doing well on follow-up. Conclusion: This case series underlines the importance of linking clinical history with lab report and bridging the gap between clinics and diagnostics so that diagnosis of rare but critical cases can be made correctly on time and timely management may be provided to prevent TLS induced mortality. Keywords: Potassium, Phosphorus, Prostate Cancer, Solid Tumours, Tumour Lysis Syndrome, Standalone laboratory, Docetaxel.

Background: Breast abscesses are a common clinical problem, especially among lactating women, traditionally managed by incision and drainage. However, this approach often results in prolonged healing, scar formation, and higher recurrence rates. Ultrasound-guided percutaneous drainage has emerged as a minimally invasive alternative, offering potential benefits in terms of reduced morbidity, faster recovery, and better cosmetic outcomes. The aim is to assess the feasibility, effectiveness, and outcomes of ultrasound-guided percutaneous drainage of breast abscesses and to compare it with conventional incision and drainage. Materials and Methods: This prospective study was conducted at the Department of Surgery and Radio Diagnosis, Sardar Vallabh Bhai Patel Hospital, Meerut, from May 2021 to October 2022. Fifty patients with breast abscesses were randomly divided into two groups of 25 each. One group underwent ultrasound-guided percutaneous drainage with repeated aspiration, while the other group was treated with conventional incision and drainage. All patients underwent relevant clinical and radiological assessments, and treatment outcomes were compared in terms of healing duration, recurrence, complications, scar formation, number of hospital visits, and need for hospital stay. Results: The majority of patients were in the 15–35 years age group, with lactational abscesses being predominant in both groups. The average amount of pus drained was comparable between the groups. Staphylococcus aureus was isolated in 40% of cases, showing maximum sensitivity to Amoxycillin-Clavulanic acid. All patients in the ultrasound group were managed with local anaesthesia, whereas 32% of the incision and drainage group required general anaesthesia or intercostal block. The ultrasound-guided group had a significantly shorter healing duration (7.16 days vs. 19.08 days, p < 0.001), no visible scar formation, and a lower recurrence rate (8% vs. 28%). Subareolar abscesses showed a particularly high recurrence rate in the incision and drainage group. Complications were fewer and less severe in the ultrasound group. Conclusion: Ultrasound-guided percutaneous drainage is a safe, effective, and minimally invasive first-line treatment for breast abscesses, providing faster healing, excellent cosmetic outcomes, and fewer recurrences. This approach should be preferred wherever facilities and expertise are available, especially in cases of subareolar abscesses, where conventional methods are associated with higher complications and recurrence rates. Keywords: Breast Abscess, Ultrasound-Guided Aspiration, Incision and Drainage, Minimally Invasive, Recurrence.

Background: In forensic anthropology and medical law, age estimation is an essential component. The pubic symphysis is a good anatomical landmark for adults to use when trying to estimate their age because of the way it changes in appearance as people get older. The purpose of this study is to use standardised phase analysis methods to examine the pubic symphysis and its phase-wise morphological alterations in relation to chronological age in people ranging from 18 to 49 years old. Materials and Methods: A cross-sectional observational study was performed on 50 human pelvic bones (25 from males and 25 from females) with known ages between 18 and 49 years. This study was conducted at Government Medical College, Siddipet between March 2023 and February 2025. The bones were acquired via medicolegal autopsies and preserved skeletal collections. Age estimation was conducted via the Todd and Suchey-Brooks phase analysis methodologies. The morphological features of the pubic symphysis were analysed, encompassing surface granularity, margin delineation, ventral rampart development, and alterations in the dorsal plateau. Each bone received a phase score, and the relationship between phase and chronological age was statistically examined by linear regression and the Pearson correlation coefficient. Results: Phase I accounted for 8% of the samples, Phase II for 12%, Phase III for 18%, Phase IV for 26%, Phase V for 22%, and Phase VI for 14%. The phase of pubic symphysis was positively correlated with chronological age (r = 0.86). Each phase's mean predicted age was very congruent with the known age. Across several stages, the estimation error varied from ±2.5 to ±5.7 years. The phase transitions in males occurred at a significantly earlier time than in females. Phases IV and V, which included participants aged 30–39, had the best accuracy rates, whereas the ages of early adults exhibited the most variation. Conclusion: A dependable way to estimate age in people between the ages of 18 and 49 is through phase analysis of the morphology of the pubic symphysis. Forensic cases involving partially decomposed or skeletonised remains can benefit from the method's excellent correlation with actual age. Nevertheless, for better accuracy, it is important to consider both inter-individual and sex-based variances. Keywords: Age estimation, Pubic symphysis, Forensic anthropology, Phase analysis, skeletal remains, Todd method, Suchey-Brooks method.

Background: One of the most important aspects of forensic investigations is accurately estimating the post-mortem interval (PMI). Results from biochemical analyses of bodily fluids to improve the accuracy of PMI estimate are encouraging. The purpose of this research is to find out which type of fluid gives more reliable biochemical indicators for PMI estimation—vitreous humour or synovial fluid—and to assess their effectiveness in calculating the time since death. Material and Methods: This prospective investigation included 60 human cadavers whose times of death were known. This study was conducted at Government Medical College, Jayashankar Bhupalpally between April 2023 and March 2025. The vitreous humour and synovial fluid samples were aseptically taken at different intervals after death, from zero to seventy-two hours. Classical biochemical techniques were employed to ascertain the potassium, sodium, urea, and creatinine concentrations. The prediction accuracy of each fluid was compared, and the association between analyte levels and PMI was evaluated by statistical analysis. Results: There was a high linear link between potassium levels in vitreous humour and PMI (r = 0.92, p < 0.001), but a moderate correlation (r = 0.78, p < 0.01) in synovial fluid. The contents of sodium and urea decreased over time in both fluids, although they were more consistent and predictable in vitreous samples. Creatinine was not very useful for PMI estimation and exhibited little change after death. In general, vitreous humour gave a more accurate and constant PMI estimate than synovial fluid, especially in the initial 48 hours after death. Conclusion: The superiority of vitreous humour as a biological fluid for postmortem interval estimation is attributed to its predictable metabolic changes and resistance to early putrefaction. Although synovial fluid has its uses, it is not as dependable as other options due to its variability. Forensic time of death estimation using vitreous humour is preferred, according to this comparison investigation. Keywords: Post-mortem interval, Time since death, Vitreous humour, Synovial fluid, Forensic biochemistry, Potassium concentration, Cadaveric analysis.

Background: Aims: To determine the effect of single medical disorder Hypertension (or) Diabetes Mellitus Vs dual medical disorder on pregnancy and perinatal outcome. Materials and Methods: Prospective observational study was conducted out over a period of 18 months. The study population consisted of pregnant women attending the hospital during the study period. The data summarizes various maternal and neonatal outcomes across different groups of gestational diabetes mellitus (GDM), hypertension (HTN), and combined GDM and HTN. The distribution of participants is analysed based on age, BMI, gravida status, and family history of diabetes mellitus and hypertension. Results: There is a significantly higher rate of jaundice and NICU admissions among babies born to mothers with combined GDM and HTN. Respiratory distress syndrome and perinatal mortality rates do not show significant differences across the groups, indicating that while some neonatal complications are more prevalent in cases of combined GDM and HTN, the overall perinatal mortality remains consistent across the conditions. Conclusions: These findings underline the importance of monitoring and managing these conditions to improve both maternal and neonatal health outcomes. Keywords: Gestational Age, Fetal Growth Restriction, Respiratory Distress Syndrome, Neonatal Intensive Care Unit.

Background: As recent trend in upper limb surgery is toward the outpatient care, brachial plexus blocks have become very popular in effectively providing perioperative anaesthesia without additional analgesia. Different agent has been added to local anaesthetic for a quicker and excellent intraoperative as well as postoperative analgesia. Adjuvant addition also results in reduction in the total volume of local anaesthetic used. As an adjuvant, midazolam is known to cause anti nociception and extend the effects of local anaesthetics with some inherent local anaesthetic properties. Purpose of the study was to assess the effect of midazolam as adjuvant, in potentiation of local anaesthetic effects in supraclavicular brachial plexus block. Materials and Methods: A hospital-based prospective comparative study was conducted after obtaining ethical committee clearance along with patient consent. 30 patients were included in each group using purposive sampling. Group A received ropivacaine with preservative free midazolam and Group B received bupivacaine with preservative free midazolam. The following parameters were noted: onset of sensory block, onset of motor block, duration of sensory block, duration of motor block, duration of analgesia, haemodynamic variables, sedation score and any complications. Results: The onset of sensory and motor blockade was significantly faster in group B compared to group A. Again, the duration of sensory and motor blockade was significantly longer in group B compared to group A. The duration of analgesia was also significantly longer in group B compared to group A. Haemodynamic and sedition scores did not differ between the groups in the intra and post-operative period. Complications were almost negligible in both the groups and not significant. Conclusion: In supraclavicular brachial plexus block with midazolam as adjuvant, bupivacaine has an advantage over ropivacaine in terms of early onset of sensory and motor blockade and helps in prolonging the duration of blockade as well as duration of analgesia. Keywords: Bupivacaine, Ropivacaine, Midazolam, Supraclavicular block.

Background: Gallstone disease (GSD) is a prevalent gastrointestinal disorder influenced by multiple demographic, metabolic, and lifestyle factors. In India, increasing rates of obesity, diabetes, and changing dietary patterns have led to a rising burden of both uncomplicated and complicated gallstone presentations. This study aimed to evaluate the clinical profile, risk factors, diagnostic findings, and management outcomes of patients with gallstone disease in a tertiary care setting. Materials and Methods: A prospective observational study was conducted among 114 patients diagnosed with gallstone disease at a tertiary care hospital. Data were collected on demographics, clinical features, imaging results, laboratory parameters, surgical management, and postoperative outcomes. Risk factor associations with complicated disease were analyzed using chi-square tests, with p < 0.05 considered statistically significant. Results: The mean age of participants was 44.8 ± 13.6 years, with a female predominance (68.4%). Overweight and obesity (BMI ≥25 kg/m²) were noted in 71.8% of cases. Common presenting symptoms included right upper quadrant pain (86%), nausea (66.7%), and vomiting (45.6%). Complicated gallstone disease was identified in 14% of patients. Significant associations were observed between complications and age >45 years (p = 0.008), diabetes mellitus (p = 0.001), and parity ≥3 (p = 0.038). Elective laparoscopic cholecystectomy was the most common management modality (63.2%). Postoperative complication rates were low, with moderate–severe pain in 33.3%, wound infection in 6.1%, and no reported mortality. Conclusion: Gallstone disease predominantly affects middle-aged, overweight females, with diabetes, older age, and multiparity significantly contributing to complications. Early surgical intervention, particularly laparoscopic cholecystectomy, remains safe and effective, even in selected complicated cases. Identifying high-risk patients is essential for timely management and preventing adverse outcomes. Keywords: Gallstone disease, complications, risk factors, abdominal pain, BMI.

Background: Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens the outcome in a significant number of hospitalised patients. The concept of Acute Renal Failure (ARF) has undergone significant re-examination in recent years. Objective: To study the risk factors, outcome and follow-up of neonates with acute kidney injury (AKI), admitted in out-born neonatal intensive care unit. Materials and Methods s: This prospective observational study was conducted among all neonates admitted in Outborn Neonatal Intensive Care Unit of Chacha Nehru Bal Chikitasalaya. Duration of study was 1 year (9 months for enrollment and 3 months for follow-up). Ethics approval for the study was obtained from Institutional Ethics Committee, CNBC, Delhi. Result: Out of 144 neonates enrolled, 60 developed AKI amounting to 42% incidence of AKI in neonates admitted to NICU. Mean age of the neonates with and without AKI were comparable (6.2 vs 7.7 days). Neonates with AKI had significantly lower gestational age and birth weight in comparison to those without AKI (33.6 versus 35.7 weeks and 2105 grams versus 2365 grams respectively). Proportion of neonates diagnosed with AKI by nRIFLE and mKDIGO classification system were 42% and 40% respectively. Whereas, nRIFLE was more sensitive in identifying the neonates with AKI, mKDIGO identified neonates with more severe stages of AKI. Out of 60 neonates with AKI, eight died during hospitalization and one neonate got discharged by parents against medical advice. Out of 51 neonates discharged, 37 achieved complete renal recovery and 14 achieved partial renal recovery at the time of discharge. Conclusion: Incidence of AKI in neonates are similar irrespective of type of definition of AKI. Sepsis, birth asphyxia, nephrotoxic drug exposure, duration of mechanical ventilation and SNAP score>20 are risk factors for neonatal AKI. Neonates with AKI are at higher risk of mortality and prolonged hospital stay in comparison to those without AKI. Keywords: Risk factors, outcome, Neonates, acute kidney injury (AKI), Neonatal intensive care unit.

Background: Hepatitis C virus (HCV) infection is a silent and often overlooked burden in pregnancy, with the potential to affect both maternal and neonatal health. While its prevalence among women of reproductive age is gradually increasing, especially in resource-limited settings, structured screening and treatment protocols during pregnancy remain poorly defined. The absence of routine antenatal screening, limited awareness among healthcare providers, and concerns over antiviral use during pregnancy contribute to delayed diagnosis and management. As vertical transmission becomes a growing concern, there is an urgent need to evaluate how HCV is currently addressed during pregnancy and what gaps persist in clinical practice. The objective is to assess the effects of HCV infection in pregnancy and evaluate screening, treatment status, and overall management of affected cases. Materials and Methods: This hospital-based analytical study included 24 pregnant women diagnosed with HCV infection between January and December 2023 at a tertiary care center in North India. Data were collected on demographic details, screening history, antenatal complications, and maternal and neonatal outcomes. Statistical analysis was performed to identify associations between clinical and outcome variables. Results: Most women were diagnosed incidentally during pregnancy, with a significant proportion having no prior knowledge of their HCV status. Screening was inconsistently applied, and none of the participants received antiviral treatment during pregnancy. Some adverse outcomes, including preterm births and low birth weight, were observed. Elevated liver enzymes appeared to correlate with preterm delivery. Conclusion: HCV in pregnancy remains underdiagnosed and undertreated. Integrating routine antenatal screening, improving provider awareness, and ensuring postpartum follow-up are key to reducing preventable complications and halting vertical transmission. Keywords: Hepatitis C, Pregnancy Complications, Infectious, Vertical Transmission.

Background: Hyperglycemia caused by diabetes are commonly treated in hospital emergency departments. Physicians must be skilled in diagnosing and stabilizing patients with these conditions. Diabetic Keto Acidosis and Hyper osmolar Hyper Glycemic State are best treated with standardised protocols that specifically address electrolyte repletion, insulin dosing, and fluid management. Mortality in both DKA and HHS is often related to underlying comorbidities and the precipitating insult. Aim of the study was to measure the occurrence of hyperglycaemic emergencies presenting to the Emergency Department, the factors associated and its outcome. Materials and Methods: All patients >18yr presenting to Emergency Department, RBS was checked in the initial triage room and patients were triaged according to clinical condition. In ED all patients were then evaluated and those who fulfilled the criteria were enrolled in the study. Selected patients were explained about the study and Written Informed consent was taken from all the participants. Socioeconomic, clinical, and laboratory data and patient’s respective outcomes were extracted from the data obtained. Statistical analysis was done using SPSS Version 22. Results: This study has demonstrated the variable epidemiology of hyperglycaemic emergencies with DKA being most common and HHS least common. Longer in-hospital stay and associated mortality are major issues with hyperglycaemic emergencies. Conclusion: Patient who arrives in the ER with high blood sugars can be risk stratified early and aggressive management can be instituted in the Emergency Room itself. This will help in preventing long term complications for the patients. Keywords: Diabetic emergencies, diabetic keto acidosis, hyper osmolar hyperglycaemic state, mortality, length of hospital stay.

Background: Polycystic Ovary Syndrome (PCOS) is associated with insulin resistance (IR), a major contributor to its pathophysiology. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) is commonly used for IR evaluation, but it requires insulin assays. The Triglyceride-Glucose (TyG) index is an emerging, simple, and cost-effective surrogate marker for IR. Objective: To compare the TyG index with HOMA-IR in women with PCOS and assess its utility as a diagnostic tool for insulin resistance. Materials and Methods: This cross-sectional study included 50 PCOS patients and 50 age-matched healthy controls. Anthropometric and biochemical parameters were measured. HOMA-IR and TyG index were calculated. Correlations and ROC analysis were performed to assess the predictive value of TyG index. Results: PCOS patients had significantly higher BMI, fasting insulin, triglycerides, HOMA-IR, and TyG index (p < 0.001). TyG index positively correlated with HOMA-IR (r = 0.64, p < 0.001). ROC analysis for TyG yielded an AUC of 1.00 with an optimal threshold of 8.541 (sensitivity 98%, specificity 100%). Conclusion: The TyG index is strongly correlated with HOMA-IR and shows excellent predictive ability for insulin resistance in PCOS patients. It may serve as an important marker than HOMA-IR, especially in resource-limited settings for early clinical diagnosis management of PCOS and improve fertility in reproductive women. Keywords: PCOS, insulin resistance, TyG index, HOMA-IR, metabolic markers.

Background: Raised intracranial pressure (ICP) is a critical emergency [8] in pediatric care. This study compares the efficacy and safety of 3% hypertonic saline (NaCl) and 20% mannitol. Materials and Methods: This was a prospective observational study conducted from July to December 2024 in a tertiary pediatric ICU. Thirty-five children with raised ICP were enrolled: 18 received 3% NaCl and 17 received mannitol. Primary outcome was clinical improvement in ICP features within 1 hour. Results: Clinical improvement was observed in 67% of the NaCl group vs 53% of the mannitol group. Hypernatremia occurred in 22% of the NaCl group; hypokalemia in 12% of the mannitol group. Mortality was lower in the NaCl group (no mortality) compared to mannitol (5.9%). Conclusion: 3% hypertonic saline may be a more effective and safer alternative to mannitol in managing raised ICP in pediatric,[5] patients. Keywords: Hypertonic saline, Mannitol, Intracranial pressure, Pediatric ICU, Osmotherapy, Neurocritical care, Raised ICP

Background: Pneumonia accounts for approximately 400,000 deaths annually in India and contributes to 13%–16% of all pediatric hospital mortality. Preventive strategies include well-established child survival measures such as expanding vaccination coverage, promoting proper nutrition, and reducing indoor air pollution. Alongside standard case management, it is crucial for caregivers—particularly mothers—to recognize warning signs that help differentiate between severe and non-severe respiratory infections. This study aims to assess the knowledge, attitudes, and practices of mothers of children under five years of age regarding acute respiratory infections and their associated warning signs. Materials and Methods: This community-based cross-sectional study was conducted in both rural and urban field practice areas affiliated with a private medical college in Gajraula, Uttar Pradesh. A multistage random sampling technique was employed to obtain a representative sample of mothers. The sample size was calculated to be 600, based on an assumed prevalence of ARI-related knowledge among mothers of 50%, a 95% confidence level, an absolute error margin of 5%, and a design effect of 1.5. Data collection was carried out using a pre-tested, semi-structured questionnaire. Categorical variables were summarized using frequencies and proportions. The association between various independent variables and outcome measures was assessed using the Chi-square test. Results: Among the 600 mothers who participated in the study, 79.6% demonstrated good knowledge, 77% exhibited a positive attitude and 68.6% followed appropriate practices which were related to the management of acute respiratory infections (ARI). A significant association was also found between good knowledge, attitude, and practices (KAP) and the mother's level of education as well as the socio-economic status of the family. The effectiveness of the health talks in improving maternal knowledge was evaluated using McNemar’s test for paired categorical data. For all the questions, p-value was found to be <0.05, indicating a statistically significant improvement in knowledge following the intervention. Conclusion: A good level of knowledge regarding acute respiratory infections (ARI), including awareness of its common symptoms such as cough, fever, and difficulty in breathing, as well as understanding the importance of early recognition and appropriate management, was demonstrated. In addition, they showed a positive attitude toward essential aspects of home-based care, such as continuing breastfeeding and proper feeding during illness, adhering to prescribed treatment, and ensuring timely immunization of their children. Keywords: Acute Respiratory Infections, Respiratory Tract Infections, Child, Preschool, Health Knowledge, Attitude, Practice.

Background: Acute appendicitis is one of the most common causes of acute abdominal pain that requires surgical intervention. Despite advances in diagnostic and imaging modalities early and accurate diagnosis remains a challenge. Biochemical markers such as total leukocyte count (TLC), C-reactive protein (CRP) and serum bilirubin are increasingly studied for their diagnostic value. Materials and Methods: This prospective observational study was conducted over two years in the Department of Surgery at GMCH Chandigarh. Fifty patients clinically and on the basis of imaging diagnosed with acute appendicitis and undergoing appendectomy were included. Preoperative biochemical markers TLC, CRP, and serum bilirubin were assessed and compared with intraoperative findings and histopathological examination (HPE), the latter serving as the gold standard. Statistical analysis was done using SPSS version 23 and p value less than 0.05 was taken as statistically significant. Results: We found a male predominance (72%) with a mean age of 35.86 years. HPE confirmed acute appendicitis in 66%, gangrenous in 24%, and perforated in 10%. Increased CRP was found to be associated with complicated appendicitis cases (p=0.045). Raised TLC count was also found to be associated with complicated appendicitis (p=0.045). Serum bilirubin was elevated in 56% however it did not show a statistically significant correlation with complicated appendicitis (p=0.569). Combined elevation of CRP and TLC improved sensitivity and specificity for predicting complicated appendicitis cases (p=0.004). Conclusion: Elevated CRP and TLC levels are reliable indicators for acute and complicated appendicitis. While serum bilirubin showed limited independent predictive value it can complement other markers. Routine assessment of CRP and TLC in addition to clinical evaluation enhances early diagnosis of acute appendicitis. Keywords: Appendicitis, CRP, Leucocytosis, Hyperbilirubinemia, Perforation.

Background: Large wound closure remains a surgical challenge, especially in settings with limited resources. Traditional techniques like grafts or flaps may be costly, technically demanding, and associated with complications. Skin-stretching techniques harness the viscoelastic and creep properties of skin to achieve delayed primary closure. Objectives: To evaluate the feasibility, effectiveness, and safety of using sterile nylon cable ties as a cost-effective method for skin stretching and closure of large wounds. Materials and Methods: A prospective case series was conducted in the Department of General Surgery, Government Stanley Medical College & Hospital, Chennai from January 2025 to April 2025. Five patients with large, healthy wounds post-debridement or fasciotomy were included. Sterile cable ties were applied across wound margins and progressively tightened 1–3 mm daily. Wounds were monitored for approximation, healing, complications, and functional outcomes. Results: Complete wound closure was achieved in 4 out of 5 patients. In one case, partial closure was followed by secondary suturing. No cases of skin necrosis or compromised limb function were observed. The average wound approximation rate ranged from 2 to 3.2 mm/day. The technique allowed wound healing with preserved sensation and mobility, and minimal scarring. Conclusion: Cable tie-based skin stretching is a safe, economical, and effective method for closing large wounds. It offers a viable alternative to commercial skin-stretching systems in low-resource settings and warrants further study. Keywords: Wound closure, Skin stretching, Tissue expansion, Cable ties, Viscoelasticity, Mechanical creep, Low-cost surgery.

Background: Intrathecal adjuvants like clonidine and dexmedetomidine are used to increase the quality and duration of spinal anesthesia. This particular study intended to compare their efficacy and safety when given in mixture with hyperbaric bupivacaine during lower abdominal surgeries. Materials and Methods: In this prospective randomized double-blinded study, 56 adult patients (ASA I/II) listed for an elective lower abdominal surgery were enrolled. The 56 patients were randomly assigned to two equal groups: Group BC (bupivacaine + clonidine 30 µg) and Group BD (bupivacaine + dexmedetomidine 5 µg). All patients were given standardized spinal anesthesia. Primary outcomes were onset and duration of sensory and motor block and time to the first rescue analgesia. Secondary outcomes were level of sedation, hemodynamic parameters, and adverse events. Results: The onset of sensory and motor block was significantly faster in Group BD (3.2 ± 0.9 min and 4.5 ± 1.1 min, respectively) compared with Group BC (4.6 ± 1.1 min and 6.1 ± 1.4 min, p<0.001). Furthermore, Group BD also demonstrated statistically longer periods of sensory and motor blockade (223 ± 24 min and 188 ± 21 min) against Group BC (173 ± 22 min and 138 ± 18 min, p<0.001). Time to rescue analgesics was delayed in Group BD (255 ± 27 min) versus Group BC (206 ± 25 min, p<0.001). Sedation scores were comparably higher with Group BD where the safety profile was acceptable. The incidence of hypotension and bradycardia was notably higher in Group BD (21.4% and 14.3%, respectively), but could be well managed. Conclusion: In sum, intrathecal dexmedetomidine is preferred over clonidine as an adjunct to bupivacaine for producing a faster onset, prolonged block duration, and prolonged analgesia; thus, from the perspective of enhancing spinal anesthesia for lower abdominal surgeries, it becomes the better choice. Keywords: Intrathecal anesthesia, dexmedetomidine, clonidine, bupivacaine, spinal block, lower abdominal surgery, postoperative analgesia, adjuvants, sedation, hemodynamic stability.

Background: A platelet count below 150,000/mm³ is classified as thrombocytopenia and is categorised into mild, moderate and severe. The integration of extended platelet indices into routine diagnostics has enhanced the ability to differentiate the causes of thrombocytopenia. Aim: To evaluate the clinical relevance of extended platelet indices (Mean Platelet Volume [MPV], Platelet Distribution Width [PDW], Platelet large cell ratio (P-LCR) and Plateletcrit [PCT]) in thrombocytopenia assessment, exploring their potential as additional diagnostic and prognostic markers. Materials and Methods: This was prospective study conducted in tertiary care hospital on 50 thrombocytopenia cases. Platelet indices were measured using 6-part automated hematology analyser and peripheral smears were reviewed. Patients were categorized by etiology, thrombocytopenia severity and mechanism (hyperdestructive vs. hypoproliferative), results were analysed across these subgroups. Results: The study comprised 50 patients diagnosed with thrombocytopenia. The majority of participants (36%) were between 41–60 years with 48% male and 52% females. The most common cause of thrombocytopenia was sepsis (28%), followed by dengue fever (22%) and viral infections (16%). Majority of the cases had moderate thrombocytopenia (52%). Analysis of platelet indices across different causes of thrombocytopenia demonstrated distinct variations. Conclusion: The extended platelet indices (Mean Platelet Volume [MPV], Platelet Distribution Width [PDW], Platelet large cell ratio [P-LCR] and Plateletcrit [PCT]) offer insight into thrombocytopenia causes and prognosis. Integrating platelet indices could reduce unnecessary procedures like bone marrow biopsies. Keywords: Mean Platelet Volume, Platelet Distribution Width, Platelet large cell ratio, Plateletcrit.

Background: Rabies is a highly fatal viral encephalitis, with domestic dogs accounting for 99% of human fatalities globally. Annually, rabies claims over 59,000 lives, with a significant burden in India. Despite the availability of vaccines, rabies remains uncontrolled due to inadequate awareness and insufficient post-exposure prophylaxis (PEP) measures. This study assesses rabies awareness, attitudes, and post-bite practices in an urban population in Patna. Materials and Methods: A cross-sectional study was conducted at the Urban Health & Training Centre, AIIMS Patna, using a semi-structured questionnaire. Data were collected from 101 participants who had experienced animal bites. Descriptive statistics were used to summarize data, while Chi-square tests and binomial logistic regression identified predictors of knowledge levels. Results: Of the participants, 67.3% were aware of rabies, with most information coming from family and friends (52.5%). Knowledge regarding post-bite wound care and PEP was low, with only 42.6% aware of appropriate first-aid measures. Logistic regression analysis revealed that age, income, and sources of information significantly influenced rabies knowledge. Health-seeking behaviors post-bite were suboptimal, with only 6% consulting faith healers, reflecting better attitudes in the urban population. Conclusion: Despite moderate rabies awareness, there are significant gaps in post-bite practices and PEP knowledge. Targeted public health campaigns focusing on proper wound care and timely vaccination are crucial to improving rabies prevention in urban populations. Keywords: Rabies, awareness, post-exposure prophylaxis, animal bites, Patna, health-seeking behavior.

Background: Infections primarily affecting structures of respiratory tract below the larynx are termed as lower respiratory tract infections (LRTI). Included generally are conditions like pneumonia, bronchitis, bronchiolitis, and viral wheeze. Objective: To study the diagnostic role of microbiology and radiology in differentiating viral and non viral community acquired lower respiratory tract infections in children between 2month -59months. Materials and Methods: The study was conducted on 60 patients admitted with the diagnosis of lower respiratory tract infections in department of pediatric medicine, chacha Nehru bal chikitsalaya, New Delhi from the period November 2018 to October 2019. Results: Out of 60 patients, 29 patients were fulfilling the criteria for viral LRTI and rest 31 were grouped as non viral LRTI and were started on antibiotics on day 1 of admission. Of the 29 patients diagnosed with viral LRTI, antibiotics were added to 3 patients in view of clinical sickness at the time of admission. Thus there were 26 patients in the study who received no antibiotics and were managed symptomatically, and the rest 34 patients received antibiotics. 2 patients went LAMA and rest of the patient were discharged. Among 60 patients enrolled in the study PCR test could be done for only 46 patients due to non availability of the kit for further testing. And in view of limited availability of the resources and time I’m presenting my results on 46 microbiologically diagnosed LRTI. 46 patients samples were subjected to PCR analysis for 32 respiratory pathogens, and single viral and bacterial pathogen was isolated in 11 and 5 patients respectively, 23 patients showed both viral and bacterial pathogens and 7 tested negative for all the organisms. Thus patients showing isolation of only viral organisms were grouped under viral and rest all were grouped as non viral which includes patients with pure bacterial isolations, with co infection and those tested negative for all organism. Conclusion: By using a predefined criteria 72% of viral pneumonias were correctly diagnosed and were discharged without antibiotics. Thus it is concluded that it is possible to differentiate viral and non viral LRTI by using clinical and simple investigative methods. Keywords: Microbiology, Radiology, Viral, non viral, Community acquired, lower respiratory tract infections.

Background: Paraquat poisoning remains a major public health issue in developing countries due to its high toxicity and easy availability. Despite its lethality, data on clinical course, treatment outcomes, and predictors of mortality are limited. The objective is to evaluate clinical features, outcomes, and predictors of mortality among patients admitted with paraquat poisoning at a tertiary care center in South India. Materials and Methods: This cross-sectional study included 101 patients with confirmed paraquat poisoning. Data on demographics, clinical presentation, lab findings, treatments, and outcomes were analyzed using descriptive statistics and chi-square tests. Results: The observed mortality rate was 78.2%, with all cases involving intentional ingestion. Most patients were male (94.6%). Deceased patients had a higher mean age (36.2 years) compared to survivors (29.6 years). Mortality was significantly associated with the amount ingested (p = 0.0037); patients who consumed <100 mL had better outcomes. AKI and ALI were strong predictors of death (p = 0.001 and 0.000). Hemodialysis was used in 36.63% of cases but showed no survival benefit. Empirical therapies (corticosteroids, cyclophosphamide, N-acetylcysteine) were widely used but did not improve survival. Time from ingestion to hospitalization was not significantly related to outcome. Conclusion: This study confirms the high mortality linked to paraquat poisoning and identifies ingestion volume, AKI, and ALI as key predictors. Common treatments showed no significant benefit, highlighting the lack of effective therapy. These findings support the urgent need for a global paraquat ban and further research into better treatment strategies. Keywords: Paraquat Poisoning, Acute Kidney Injury, Acute Liver Injury, Mortality, Public Health Issue.

Background: Cervical lymphadenopathy is a common clinical presentation with a wide range of etiologies, including infectious, inflammatory, and malignant causes. This study aimed to evaluate the clinical and diagnostic profiles of patients presenting with cervical lymphadenopathy at a tertiary care hospital. Materials and Methods: A prospective observational study was conducted in the Department of Surgery at the Himalayan Institute of Medical Sciences, Dehradun, over 12 months. A total of 57 patients with cervical lymphadenopathy were enrolled. Detailed clinico-demographic data, along with lymph node characteristics, were recorded. Fine needle aspiration cytology (FNAC) or biopsy was performed for diagnostic confirmation. Statistical analysis was conducted using SPSS software (version 23), with a p-value of <0.05 considered statistically significant. Results: The average age of patients was 46.16±18.95 years. Tuberculosis (TB) was the most common diagnosis (52.63%), followed by carcinoma (21.05%) and reactive lymphoid hyperplasia (RLH) or lymphoproliferative disorders (22.81%). Carcinoma patients had the highest mean age (60.25 years, p<0.0001). TB patients showed matted nodes (100%), while carcinoma nodes were hard (100%). Oral infections were significantly associated with RLH/PD (p<0.0001). Conclusion: TB remains the most frequent cause of cervical lymphadenopathy, while carcinoma is more prevalent in older patients. Lymph node characteristics and associated conditions can aid in diagnosis and management. Keywords: Cervical lymphadenopathy, tuberculosis, carcinoma.

Background: Attention-deficit/hyperactivity disorder (ADHD) is frequently accompanied by developmental delays and psychiatric comorbidities that vary across clinical subtypes. Understanding these subtype-specific associations is essential for early identification and individualized care. Materials and Methods: This cross-sectional study was conducted in the psychiatry outpatient department of a tertiary care hospital and included 50 children aged 5–17 years diagnosed with ADHD and normal intellectual functioning. Diagnostic classification was based on DSM-IV-TR criteria and ADHD Rating Scale IV. Developmental delays across motor, language, and social domains were assessed through clinical evaluation. Comorbid psychiatric disorders were identified using DSM-IV-TR diagnostic guidelines. Data were analyzed using SPSS version 11.5, with descriptive statistics and chi-square tests applied where appropriate. Results: Developmental delays were observed in 50% of participants, with language delays being the most prevalent (47.1%). Delays in gross motor development were noted in 8.8%, while fine motor delay was absent. Social developmental delay was seen in 2.9% of cases. Among ADHD subtypes, the combined type was most frequent (66%), followed by inattentive (24%) and hyperactive-impulsive (10%) subtypes. Patterns of psychiatric comorbidities varied significantly across subtypes. The inattentive group exhibited higher rates of anxiety and depressive disorders, while the combined type had greater frequency of externalizing disorders such as oppositional defiant disorder and conduct disorder, as well as neurodevelopmental conditions including intellectual disability, seizure disorders, and autistic traits. Conclusion: Children with ADHD, even those with normal cognitive functioning, frequently exhibit developmental and psychiatric comorbidities. The distribution of these comorbid conditions varies by ADHD subtype, underscoring the need for comprehensive, subtype-specific assessment. Early recognition and tailored interventions are vital for improving outcomes in this population. Keywords: ADHD, developmental delay, psychiatric comorbidity, ADHD subtypes, children.

Background: Recurrent abdominal pain (RAP) is one of the most common medical complaints during childhood and adolescence. Approximately 10% of school aged children get recurrent episodes of abdominal pain. The prevalence of RAP in children ranges from 10 to 20%. RAP was defined as ≥3 bouts of abdominal pain severe enough to interfere with activities, appearing in a period of ≥3 months. The Rome III criteria4 now categorize abdominal pain into 1. Functional dyspepsia (FD). 2. Functional abdominal pain (FAP) and functional abdominal pain syndrome (FAPS). 3. irritable bowel syndrome (IBS). 4. Abdominal migraine. Pain localization in younger children is poor, and in a suffering child, physical examination is often limited. Thus, sonographic evaluation of the abdomen is frequently performed in children to investigate the reason for the pain and to exclude other acute abdominal surgical conditions. AIM: To assess patients with recurrent abdominal pain in pediatric age group clinically and then correlate with ultrasonography. Objective: 1. To clinically assess recurrent abdominal pain in pediatric patients. 2. To evaluate them by ultrasound. 3. To correlate the clinical assessment with ultrasonography findings. 50 Material and Methods: This was a prospective study done on all cases of recurrent abdominal pain presenting to the Pediatrics department between 8-18 years of age over period of 18 months in Department of Pediatrics and Department of Radiology, at SGT Medical College Hospital and Research Institute, Gurugram. Study size: 50 Pediatric patients. The clinical criteria for diagnosis of recurrent abdominal pain refers mainly to the duration of painful period and frequency of pain which should be at least three months in the preceding period, and over this three-month period, there are at least three episodes of pain that are severe enough to affect the daily activities of the affected patients. Inclusion criteria 1. All children 8 to 18 years of age with recurrent abdominal pain, would form the study group. 2. Their clinical features and radiological findings would be assessed. 3. The study group will be divided into two age groups;8yr-12yr, 12yr-18yr. 51 Exclusion criteria: 1. Acute abdominal pain. 2. Physiological pain during menstruation cycle (dysmenorrhea) in females. 3. Patients with post-operative pain or pain due to trauma. Patients enrolled in the study, were the ones with clinical diagnosed recurrent abdominal pain. Laboratory and radiological evaluation were done for each patient. Radiological assessment was done using ultrasonography. Observations and Results: Amongst 450 paediatric cases with abdominal pain, a total of 50 were identified as recurrent abdominal pain based on clinical presentations and prevalence was observed as 11.11%. Among 50 cases of RAP cases predominating higher male cases were observed 28 (56%) as compared to the female cases 22 (44%). Highest number of patients were received from age 9 years i: e 20 patients, followed by 09 patients from 8 years of age, 07 patients from 13 years of age, 06 patients from 11 years of age, 05 patients from 12 years of age and only 03 patients from 10 years of age. P value was

Background: Water polo is physiologically, a highly demanding activity, where players need technical, tactical, and physical skills to succeed. Hematological parameters allow evaluation of anemic and immunological states of the subjects. The aim of the study was to determine hematological profile of trained water polo players and to compare the values between trained water polo players and non-athletes. Materials and Methods: Hematological profile of 40 trained male water polo players & 40 healthy male non-athletes was assessed by assaying a venous sample for RBC, HB%, HCT, MCV, MCH, MCHC, SE(Fe), TIBC, WBC, PLT, LYM %, MON %, GRAN %. Results: SE(Fe) and TIBC values were significantly lower in water polo group. while PLT, LYM% and MON% showed significant increase. In all other variables there was no statistically significant difference. Conclusion: Hematological profile obtained is probably due to age, androgen affection on erythropoiesis, diet and bear relationship to swimming training. From a practical point of view, the clinician has to take into account not only the age, but also the training status of individuals when evaluating their blood tests. Key words: Water Polo, Hemtological Parameters.

Background: The aim is to dosimetrically analyze Volumetric Modulated Arc Therapy (VMAT), Intensity Modulated Radiotherapy (IMRT) and Three Dimensional Conformal Radiotherapy (3D-CRT) to find the optimal technique in the treatment of post mastectomy left sided chest wall and supra-clavicular irradiation. Materials and Methods: Twenty consecutively treated left sided breast cancer patients were selected. Radiation therapy plans were generated on Radiation Planning CT Scan with each Radiotherapy Modalities (IMRT, VMAT, 3D-CRT). Three plans were generated for each patient and compared. Results: VMAT technique provided a statistically significant homogenous (p<0.0001) and conformal dose distribution (p<0.00001) with a mean HI of (0.16 ± 0.03) and mean CI of (0.94 ± 0.01), compared to mean HI of (0.22 ± 0.06) and mean CI of (0.91 ± 0.04) with IMRT technique and mean HI of (0.27 ± 0.06) and mean CI of (0.83 ± 0.04) with 3D-CRT. For ipsilateral lung and heart, VMAT technique significantly reduced the high-dose volumes where the mean V20 to lung was (32.93 ± 3.16) vs (39.17 ± 2.43) vs (46.65 ± 4.16) for VMAT, IMRT and 3D-CRT respectively (p<0.0001) and mean V30 to heart was (6.81 ± 2.28) vs (11.29 ± 3.44) vs (19.85 ± 7.98) in VMAT, IMRT and 3D-CRT techniques respectively (p<0.0001). But 3D-CRT was found to be superior in case of reducing low dose volumes to the ipsilateral lung, heart, contralateral lung and breast. Conclusion: VMAT plans in left sided chest wall irradiation should be used in selected cases keeping the dose distribution and normal tissue dose constrains in mind. Keywords: CI: Conformity Index, CTV: Clinical Target Volume, DVH: Dose Volume Histogram, 3DCRT: 3 Dimensional Radiation Therapy, GTV: Gross Tumor Volume, HI: Homogeneity Index, MLC: Multi Leaf Collimator, MU: Monitor Units, OAR: Organ at Risks, RT: Radation Therapy, PTV: Planning Target Volume, SCF: Supra-clavicular Fossa

Background: Neonatal meningitis remains a major cause of morbidity and mortality worldwide. Cerebrospinal fluid (CSF) sugar levels are a critical diagnostic parameter; however, their correlation with long-term neurological outcomes is not well established. Aim: To evaluate the correlation between CSF sugar levels in neonatal meningitis and subsequent neurological morbidity. Materials and Methods: This prospective observational study included 200 neonates diagnosed with meningitis at [Hospital Name]. CSF sugar levels were measured at presentation. Neurological outcomes were assessed during follow-up at 3-, 6-, and 12-months post-discharge. Statistical analysis examined associations between initial CSF sugar levels and neurological sequelae. Results: The mean CSF sugar was significantly lower in neonates who developed neurological morbidity (32.6 ± 9.7 mg/dL) compared to those without morbidity (p < 0.001). Neonates with CSF sugar <20 mg/dL had a higher incidence of severe neurological complications, including seizures, cerebral palsy, and developmental delay (p < 0.001). Approximately 28.5% of the cohort experienced neurological morbidity during follow-up. Conclusion: Low CSF sugar levels at presentation strongly correlate with increased risk and severity of neurological morbidity in neonatal meningitis. CSF glucose measurement serves as an important prognostic tool to guide early intervention and follow-up. Keywords: Neonatal meningitis, Cerebrospinal fluid sugar, Neurological morbidity.

Background: Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes mellitus, often leading to hospitalization and lower limb amputations. Negative Pressure Wound Therapy (NPWT) has shown promise in improving wound healing. This study evaluates the efficacy of a cost-effective, Homemade Vacuum Assisted Closure (HVAC) system compared to conventional saline gauze dressing (SGD) in the management of DFUs. Materials and Methods: A prospective, randomized controlled trial was conducted on 60 patients with diabetic foot ulcers admitted to Sir J.J. Group of Hospitals, Mumbai. Participants were divided into two groups: HVAC (n=30) and SGD (n=30). Key outcomes assessed included hospital stay, wound granulation, graft uptake, ulcer area reduction, rate of infection, and surgical intervention rates. Results: The HVAC group showed a significantly shorter mean hospital stay (37 vs. 49.7 days, p < 0.01), higher granulation tissue coverage (97.5% vs. 93.4%, p = 0.002), and greater ulcer area reduction post-intervention (29.3 cm² vs. 20.4 cm²). Although graft uptake was slightly higher in the HVAC group (96.7% vs. 94.3%), the difference was not statistically significant (p = 0.06). Infection rates were significantly lower in the HVAC group, with 53% showing negative wound cultures compared to none in the SGD group (p < 0.01). Rate of granulation formation was also higher with HVAC (0.76 vs. 0.50 cm²/day, p = 0.048). Conclusion: Homemade NPWT using HVAC significantly enhances wound healing, reduces infection rates, and shortens hospital stay compared to conventional saline gauze dressings in diabetic foot ulcers. Given its low cost and effectiveness, HVAC presents a viable alternative for wound management in resource-constrained settings. Further studies with larger sample sizes are warranted to validate these findings. Keywords: Negative Pressure Wound Therapy (NPWT), Homemade Vacuum Assisted Closure (HVAC), Conventional Dressing, Diabetic Foot Ulcers.

Background: Autophagy plays a crucial role in maintaining cellular homeostasis, and its dysregulation has been implicated in the pathogenesis of type 2 diabetes mellitus (T2DM) and its complications, including diabetic nephropathy (DN). This study aimed to evaluate key autophagy markers in T2DM patients with and without DN. Materials and Methods: A total of 66 T2DM patients were enrolled and divided into two groups: 33 with DN (cases) and 33 without DN (controls). Serum levels of autophagy markers (LC3-II, Beclin-1, and p62/SQSTM1) were measured using ELISA. Clinical and biochemical parameters, including fasting blood glucose (FBG), HbA1c, serum creatinine, and urinary albumin-to-creatinine ratio (UACR), were also assessed. Results: DN patients exhibited significantly higher levels of p62/SQSTM1 (p<0.01) and lower levels of LC3-II and Beclin-1 (p<0.05) compared to non-DN diabetic patients. A positive correlation was observed between p62 and UACR (r = 0.52, p<0.01), while LC3-II and Beclin-1 showed negative correlations with renal function markers. Conclusion: Impaired autophagy, indicated by altered levels of LC3-II, Beclin-1, and p62, is associated with DN in T2DM patients. These markers may serve as potential indicators of disease progression and therapeutic targets. Keywords: Autophagy, Diabetic nephropathy, Type 2 diabetes, LC3-II, Beclin-1, p62.

Background: Neuromuscular blocking agents (NMBAs), such as rocuronium, are commonly used for intubation and in surgical conditions. Sugammadex, a selective relaxant binding agent, provides rapid reversal of neuromuscular blockade (NMB), unlike traditional agents. Objective: This study compares the effects of Sugammadex at doses of 2 mg/kg and 4 mg/kg in patients undergoing laparoscopic cholecystectomy, focusing on neuromuscular recovery and extubation time. Materials and Methods: A two-year observational study at Santosh Medical College included 90 ASA I or II patients aged 18 and older. Participants were divided into two groups based on train-of-four (TOF) counts: Group A (2 mg/kg) for TOF counts more significant than two and Group B (4 mg/kg) for TOF counts of 1-2. Primary outcomes included recovery time from NMB. Results: The extubation time was shorter in Group B (1.81 ± 1.08 min) compared to Group A (3.78 ± 1.28 min, p = 0.001). Both groups showed improvements in oxygen saturation and respiratory parameters, although Group B had a transient increase in systolic blood pressure. Faster recovery of the faster-twitch response was observed in the 4 mg group. Conclusion: A 4 mg/kg dose of Sugammadex leads to faster neuromuscular and respiratory recovery compared to a 2 mg/kg dose, indicating its advantages over traditional reversal agents. Further multicenter studies are needed to confirm these findings. Keywords: Sugammadex, Reversal Agent, Laparoscopic Cholecystectomy.

Background: Chronic liver disease is characterized by gradual destruction of hepatic tissue over time. The most common complication of chronic liver diseases is portal hypertension. Gastro esophageal varices, ascites, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome and hypersplenism develop as a consequence of portal hypertension. As a novel noninvasive assessment method, transient elastography has become highly useful because of its accuracy, simplicity, and rapid results. In particular, transient elastography can accurately predict liver cirrhosis. Objective: To correlate the liver stiffness measurement by fibroscan with presence of esophageal varices in patients of liver cirrhosis. Materials and Methods: The present Descriptive observational study was carried out at Department of Gastroenterology at Guntur Medical College, Guntur Andhra Pradesh, India during June 2024 to March 2025 involving 50 patients who are newly diagnosed as liver cirrhosis. Statistical analysis was carried out using SPSS 24.0 version. Results: Out of 50 cases, majority were from 51-70 years i.e. 50%. Mean age of the study population was 54.13±13.81 years. Most common etiology of cirrhosis among our patients followed by alcohol (42%). 76.0% of the patients were with CTP Class B which was significantly higher than other patients with CTP Class A and B of the patients (24.0%) (p<0.0001). The association between etiology of cirrhosis and fibroscan was not significant (p>0.05). Grades of esophageal varices increased significantly with increase in Fibroscan (E Score) (p<0.05). Conclusion: The association between etiology of cirrhosis and fibroscan was not significant (p>0.05). Thus, in our study, grades of esophageal varices increased significantly with increase in Fibroscan (E Score) (p<0.05). Key words: Liver stiffness, fibroscan, esophageal varices, liver cirrhosis.

Background: The present Randomised comparative study was conducted in the Department of Anesthesiology at tertiary care hospital, after Institutional review Board approval on 60 adult patients posted for elective surgical surgeries under General Anesthesia, with ASA grade I and II, in age group of 18-60 years, having EGRI < 7. The patients were randomly divided into two groups: Group MCCOY- Patients intubated using Mccoy Laryngoscope. Group KVC - Patients intubated using King Vision Video Laryngoscope Channelled blade. Two groups were evaluated using the following parameters: Time for glottic view, time for insertion of Endotracheal tube, total time, number of attempts, optimization maneuvers, Cormarck Lehane score, ease of insertion, intubation difficulty score, hemodynamic changes, & Complications. Materials and Methods: Results: Both groups were comparable with respect to demographics. Other results obtained in the study: Time for glottic view &Time for tracheal tube insertion, Total time number of attempts, Cormarck Lehane score, POGO score,ease of insertion, Intubation Difficulty score were comparable in both groups. Optimisation Manoeuvres In GROUP KVC, Out of 30 patients, no patients required use of stylet/ bougie for intubation and 5 patients (16.67%) required other manoeuvres for successful intubation. In GROUP MCCOY, Out of 30 patients, 8 patients (26.67%) required use of stylet/ bougie for intubation and 8 patients (26.67%) required other manoeuvres for successful intubation.(P= 0.044). Hemodynamic Changes Heart Rate, Systolic BP, Diastolic BP, Mean BP. They were significantly increased in GROUP MCCOY just after intubation and 1 min post intubation compared to Group KVC. (p < 0.05) complications: in our study 3 patients of KVC group and 4 patients of MCCOY group had sore throat 2hours after extubation. Conclusion: kingvision Videolaryngoscope is better than Maccoy laryngoscope for orotracheal intubation in patients with prediction of difficult intubation Keywords: Endotracheal intubation, Channelled blade, Mccoy blade, Kingvision video laryngoscope.

Background: Foreign bodies (FBs) in the ear, nose, and throat (ENT) are frequent presentations in emergency and outpatient settings, especially among children. Prompt identification and management are crucial to prevent complications. Objective: To evaluate the types, clinical presentation, management, and complications of ENT foreign bodies encountered in a tertiary care center. Materials and Methods: A retrospective study was conducted analyzing cases of ENT foreign bodies over a specified period. Data regarding patient demographics, type and location of foreign body, symptoms, anesthesia requirements, and complications were collected and analyzed. Results: Ear foreign bodies were the most commonly encountered (46.8%), followed by esophageal (25.5%), nasal (20%), and oropharyngeal (7.7%) FBs. The majority of patients (44.7%) were under 10 years of age. Insects, seeds, and bones were among the most frequently retrieved foreign bodies. Most removals were successful under local or no anesthesia (63.8%), while 36.2% required general anesthesia. Notable complications included tympanic membrane perforation (14.5%) and one case of esophageal perforation. Conclusion: ENT foreign bodies are predominantly seen in children and require timely, skilled management to prevent complications. Awareness among caregivers and early referral to ENT specialists can significantly improve outcomes. Key words: Foreign body, ear, nose, throat, complications.

Background: In comparison with open appendectomy, laparoscopic appendicectomy has been safe and suitable. Despite the advancement in the laparoscopic technology into the field of surgery, laparoscopic appendicectomy has not shared the privilege of wide acceptance for appendicectomy. The cardinal reason could be due to cynicism towards its ability to improve upon the traditional incision method. The objective is to compare the outcomes of Laparoscopic Appendicectomy versus Open Appendicectomy in Acute Appendicitis with respect to postoperative pain, hospital stay and in-hospital complications. Materials and Methods: The present Prospective, comparative hospital-based study was carried out in 100 patients diagnosed with Acute Appendicitis undergoing either Laparoscopic Appendicectomy or Open Appendicectomy in MIMSR YCRH, Latur. The patients were divided into two groups, 50 in laparoscopic appendectomy group and 50 in open appendectomy group. Data was analysed using SPSS 20.0 version. Results: 29 males and 21 females have undergone laparoscopic appendectomy while 34 males and 16 females underwent open appendectomy. Post operative complication was found to be statistically significant during week 2 (P<0.025) and week 3 (P<0.049) review of the patients. Pain score (VAS) for laparoscopy was 1.08±0.08 hours as compared to open procedure i.e. 5±1.2 hours (p<0.01) which shows that pain was more in open procedure. Duration of hospitalization for laparoscopy was 2.26±0.44 days as compared to open procedure i.e. 5.34±1.26 days (p<0.01) which shows that hospitalization days were more in open procedure. Conclusion: Laparoscopic appendectomy is safer surgical procedure compared to open appendectomy. Keywords: Open appendectomy, laparoscopic appendectomy, postoperative pain, hospital stay.

Background: Obstructive Sleep Apnoea (OSA) is a prevalent sleep disorder characterized by recurrent episodes of upper airway collapse, leading to disrupted breathing. Type 2 Diabetes Mellitus (T2DM) is a significant risk factor for OSA due to associated obesity, insulin resistance, and metabolic dysfunction. Despite the well-established relationship between T2DM and OSA, there is a lack of studies assessing. OSA risk in diabetic patients, particularly in Northeast India. This study evaluates the risk of OSA among T2DM patients using the STOP-BANG questionnaire. Objective: To estimate the risk of OSA in patients with T2DM using the STOP-BANG score and assess its correlation with clinical and metabolic parameters. Materials and Methods: This hospital-based observational study was conducted at Tezpur Medical College and Hospital, Assam. A total of 150 T2DM patients were included based on predefined inclusion and exclusion criteria. Data collection involved personal and medical history, anthropometric measurements (BMI, neck circumference), and laboratory assessments (HbA1c, fasting blood glucose, postprandial blood glucose). OSA risk was assessed using the STOP-BANG questionnaire. Statistical analyses were performed to determine the correlation between OSA risk and clinical variables Results: Among 150 participants, 57.33% were classified as high risk (STOP-BANG score ≥5), 32.00% as intermediate risk (3-4), and 10.67% as low risk (0-2). A significant association was found between OSA risk and BMI, neck circumference, and HbA1c levels (p < 0.001). Longer diabetes duration also correlated with higher OSA risk. Conclusion: A high prevalence of OSA risk was observed among T2DM patients. Obesity, poor glycaemic control, and longer diabetes duration were significant predictors of OSA risk. Screening for OSA using the STOP-BANG questionnaire can help in early identification and intervention, potentially improving metabolic and cardiovascular outcomes in diabetic patients. Keywords: Obstructive Sleep Apnoea, Type 2 Diabetes Mellitus, STOP-BANG Score, BMI, Neck Circumference, Glycaemic Control, Sleep Disorder.

Background: COPD is commonly associated with other chronic diseases because of the common risk factors involved like cigarette smoking and obesity. These associated disease conditions might contribute significantly to the symptoms and severity in the affected patients. The diseases associated with COPD include congestive heart failure, arrhythmias, peripheral artery disease, coronary artery disease, diabetes, hypertension, osteoporosis, cachexia, chronic renal failure, infections and lung cancer. The objective is to determine whether the incidence of renal failure is more among COPD patients when compared with age matched control population. Materials and Methods: Both male and female patients with COPD as cases and without COPD as controls visiting to Medicine at Department of Medicine at Datta Meghe Institute of Medical Sciences, Nagpur during the study period from December 2023 to December 2024. Results: Majority of the cases i.e. 64% and controls i.e. 62% were from 61-70 years age group. Number of cases with abnormal serum creatine were significantly higher compared to controls (p<0.05). In our study, abnormal levels of creatine clearance were seen in 86% of cases and 50% of controls. It means number of cases with CKD severity were significantly higher compared to controls. Conclusion: CKD severity was significantly higher in COPD cases compared to controls. Our study findings strongly support the association of increased prevalence of CKD in patients with COPD. Keywords: Renal failure, COPD, Non-COPD.

Background: Objective: CD 200 is a type I immunoglobulin super family membrane glycoprotein and is expressed in many B-chronic lymphoproliferative disorders (B-CLPDs). This study aimed at analyzing the expression pattern of CD200 by flow cytometry immunophenotyping (FCI) and to evaluate its utility in narrowing down the differential diagnosis of B-CLPDS. Material and methods: A total of 38 patients of CLPD were enrolled in the study which included 23 cases of Chronic lymphocytic leukemia (CLL) 09 cases of Mantle cell lymphoma (MCL) and 06 cases of Hairy cell leukemia (HCL). Provisional diagnosis was made based on peripheral blood examination, imaging and bone marrow aspiration findings. All the 23 cases of CLL expressed CD200 with moderate-to- bright intensity (median MFI: 1174). None of the 09-mantle cell lymphoma (MCL) cases, two being CD23-positive, expressed CD200 (median MFI: 10). All six hairy cell leukemia (HCL) cases expressed CD200. CD200 expression in HCL was brightest among all the CLPDs with a median MFI of 5050. Conclusion: CD200 has an important role in differentiating CLL from MCL, especially in patients where an immunophenotypic overlap exists. HCL has a consistent and very bright expression of CD200. It would be prudent to include CD200 in the primary panel of antibodies for CLPD analysis in low resource settings. Key words: Chronic Lymphocytic Leukemia (CLL), Matutes Score. CD200 Marker, Immunophenotyping. Flow Cytometry.

Background: Asthma affects over 34 million people in India, contributing to 46% of global asthma deaths despite representing only 13% of worldwide prevalence. Uncontrolled asthma remains a significant public health challenge, with studies indicating that 60% of adults with current asthma experience uncontrolled symptoms. Understanding the multifactorial contributors to poor asthma control is essential for developing targeted interventions and improving patient outcomes. Objective: This prospective observational study aimed to assess asthma control status and identify contributing factors for uncontrolled asthma in adult patients attending a tertiary care hospital in North India. Materials and Methods: A 24-week prospective observational study was conducted at Rohilkhand Medical College, Bareilly, from February to July 2024. The study enrolled 138 patients diagnosed with uncontrolled bronchial asthma. Asthma control was assessed using GINA criteria and ACT scores at baseline, 4, 12, and 24 weeks. Demographic characteristics, symptom patterns, environmental exposures, comorbidities and adherence factors were systematically evaluated. Results: The study population comprised equal gender distribution (50% male, 50% female) with predominant age groups of 21-30 years (23.9%) and 41-50 years (20.3%). Most participants had normal BMI (58%), with 43.5% being housewives and 24.6% farmers. Common symptoms included cough (34.8%) and breathlessness (14.5%). Critical contributing factors included treatment non-compliance 41.3%, lack of adherence 68.8%, and improper inhalation techniques 58.0%. Other significant exposures included smoking (30.4%) and occupational factors (24.6%), while rhinosinusitis was the most prevalent comorbidity (49.3%). At 24 weeks, 18.8% achieved well-controlled asthma, 76.1% had partial control, and only 5.1% remained uncontrolled, representing substantial improvement from 100% uncontrolled status at baseline. Conclusion: This study demonstrates significant potential for asthma control improvement through systematic management approaches, while highlighting critical gaps in treatment adherence and proper medication delivery techniques that require targeted interventions. Keywords: Asthma, Uncontrolled Asthma.

Background: Mild head injury (MHI) is commonly associated with cranial nerve (CN) injuries, which can affect the quality of life. This study aimed to assess the incidence, types, and recovery outcomes of CN injuries in MHI patients and explore their demographic and clinical characteristics. Materials and Methods: A Retrospective observational study was conducted in the Department of Neurosurgery at Government Medical College Machilipatnam, over a one-year period From July 2024 to June 2025. The study included 50 patients with MHI, defined by a Glasgow Coma Scale (GCS) score of 13-15, who were evaluated for CN dysfunction through clinical assessment and neuroimaging. Patients with moderate or severe head injuries were excluded. Recovery was assessed at 1, 3, and 6 months using the Medical Research Council (MRC) grading system. Results: The study revealed a higher incidence of CN injuries in males (60%) and patients aged 31-40 years (30%). The most commonly affected CNs were the facial (CN VII, 30%) and olfactory (CN I, 24%) nerves. Falls were the leading cause of injury (60%). The recovery rates varied by CN type, with 80% of patients with facial nerve injuries recovering fully within six months. Recovery was lower for oculomotor nerve injuries, with only 62.5% fully recovering. Conclusion: The study highlighted the significant incidence of CN injuries in MHI patients, especially those with facial and olfactory nerve involvement. Recovery was generally favorable for facial nerve injuries, but less so for oculomotor nerve injuries. Early identification and timely management are essential for a faster recovery in such injuries. Keywords: Mild head injury, cranial nerve injuries, facial nerve, olfactory nerve, recovery, falls, Glasgow Coma Scale, neuroimaging, prospective study.

Background: Low birth weight (LBW) and preterm births are considered a major public health concern in relation to their significant contribution towards the sustainability and well-being of the population. Due to the health care burden, comprehensive interventional procedures for primary prevention are required such as Kangaroo Mother Care (KMC). Kangaroo mother care for preterm infants is also related to better cognitive and motor development at six months. Therefore, the present study was conducted to study the kangaroo mother care practices among postnatal women. Materials and Methods: A prospective observational study was carried out among 240 postnatal mothers who gave birth to preterm and/or low birth weight infants. Using a semi-structured questionnaire, socio-demographic details were collected. Data regarding proper KMC practices were collected through face-to-face interviews using a standardized questionnaire. For the practice part, direct observation was done when they positioned, breastfed, and ambulated, when the postnatal mothers were in the hospital. Using a digital baby weighing scale, the weight of the infants was recorded at 14- and 28-day follow-up. Results: The mean age of the study subjects was 23.92 ± 3.81 years. Of the 240 participants, 72.9% had preterm and 27.1% had term deliveries. The mean birth weight was 1934.6 ± 166.1 grams. Proper KMC practices were followed by most: 89.6% had ≥1-hour sessions, 91.3% ensured proper positioning, and 92.5% maintained frog position. However, only 48.3% wrapped the baby properly, and 61.7% maintained hygiene. Overall, 72.9% practiced proper KMC. Mean weight gain was significantly higher (561.5 ± 50.9 grams) in the proper KMC group compared to 509.1 ± 86.3 grams in the improper group. Conclusion: Kangaroo mother care is a simple, low-cost technique that is well acceptable to mother and family and can be continued at home. Proper kangaroo mother care practices had a significant role in weight gain among infants. Thus, kangaroo mother care is an effective alternative to conventional care for the management of stable low birth weight infants. Keywords: Low Birth Weight, Preterm, Kangaroo Mother Care, Infants, Weight Gain.

Background: Community-acquired pneumonia (CAP) remains a significant global health burden with high rates of morbidity and mortality. Early risk stratification is essential for optimal management. The neutrophil-to-lymphocyte ratio (NLR), a simple and cost-effective inflammatory marker derived from routine blood counts, has emerged as a potential predictor of disease severity and adverse outcomes in CAP. However, its utility relative to established scoring systems like CURB-65 and the Pneumonia Severity Index (PSI) remains under investigation. Objectives: To evaluate the prognostic value of NLR in hospitalized CAP patients and determine its association with key clinical outcomes, including in-hospital mortality, ICU admission, length of stay (LOS), vasopressor use, and 30-day readmission. Additionally, to compare the predictive performance of NLR with conventional severity indices. Materials and Methods: This retrospective cohort study included 2,862 adult patients admitted with non-COVID-19 CAP between [Start Date] and [End Date] at the departments of Department of TBCD and Department of Pathology, Government Medical College, Kurnool .Patients were stratified into two groups based on NLR (≤12 vs. >12). Demographic, clinical, and laboratory data were extracted from electronic medical records. Primary outcomes included in-hospital mortality and LOS; secondary outcomes included ICU admission, 30-day mortality, 30-day readmission, and vasopressor use. Multilevel logistic and Poisson regression analyses were conducted, adjusting for age, sex, Charlson Comorbidity Index (CCI), CURB-65, Hospital Frailty Risk Score (HFRS), and C-reactive protein (CRP). Results: Patients with NLR >12 had significantly worse outcomes: higher in-hospital mortality (10% vs. 6.2%, adjusted OR 1.22, p=0.009), increased ICU admission (3.0% vs. 2.4%, adjusted OR 1.41, p=0.012), and longer LOS (median 4.1 vs. 3.7 days, adjusted IRR 1.11, p<0.001). Vasopressor use was also elevated in this group (3.1% vs. 1.4%, adjusted OR 1.82, p<0.001). While 30-day mortality was higher in the NLR >12 group, the adjusted association was not statistically significant (OR 1.10, p=0.110). Interestingly, 30-day readmission was lower in the high NLR group (12.2% vs. 17.1%, p<0.001), likely reflecting higher in-hospital mortality. Conclusion: An elevated NLR (>12) at hospital admission is an independent predictor of adverse clinical outcomes in CAP, including mortality, ICU admission, prolonged hospital stay, and vasopressor requirement. Although traditional scores like CURB-65 remain robust for risk prediction, NLR offers a practical and accessible adjunct for early stratification, particularly in resource-limited settings. Further prospective validation is warranted to integrate NLR into composite risk models for CAP. Keywords: Community-acquired pneumonia, Neutrophil-to-lymphocyte ratio, Risk stratification, CURB-65, Mortality, Biomarkers, Inflammation.

Background: Regional anaesthesia has been the cornerstone for elective hemorrhoidectomy. Peri-operative anxiety is a common problem encountered in adults. Virtual Reality (VR) is a computer-generated environment with scenes and objects that appear to be real, making the user feel they are immersed in their surroundings. This study aims to understand the effects of VR on the peri-operative anxiety and variation in the intra-operative hemodynamic parameters of these patients. Materials and Methods: After ethical committee approval, single-blinded randomised clinical study was conducted,after taking informed written consent on 32 Patients, aged 18 to 60 years, ASA I & II, undergoing elective hemorrhoidectomy after meeting inclusion and exclusion criteria . Study intervention: 32 patients are randomly divided into two groups. Group A- Non interventional Control group (n=16); Group B- Immersive virtual reality group (n=16). Anxiety of the patients was assessed 1 day prior to surgery and in the peri-operative period .Intra-op hemodynamics; patient’s hemodynamic parameters are noted at 0,1,2,5,10,20,30,60,120,240 minutes.. Results: It was found that the anxiety scores among participants in the intervention group were lower than the anxiety scores of participants in the non-intervention group. The mean difference was found to be statistically significant in post 30 minutes stage(P = 0.001) and post operative stage(P=0.002). It was found that participants in the VR intervention group had statistically significantly lesser heart rate at 5,10,30 and at 60 minutes respectively. For all other time intervals, the heart rate was found to be comparable. It was observed that participants in the VR intervention group had lower systolic blood pressure than participants in the non-intervention group from 5 minutes to 120 minutes respectively. It was found that participants in the intervention group had lower diastolic blood pressure than participants in the non-intervention group at 10 minutes, 30 minutes, 60 minutes, 120 minutes, and 240 minutes respectively. Conclusion: The study concluded that immersive virtual reality reduced patient anxiety in the peri-operative period and had lower gradual effect on the hemodynamics. The role of VR in hemodynamic stability of the patient in peri-operative period was significant in only few intervals and can be investigated further. Keywords: Regional anaesthesia, Hemorrhoidectomy surgery, Virtual Reality, Peri-operative Anxiety, Hemodynamic Parameters.

Background: Febrile seizures are the most prevalent seizures in children aged between 6 – 60 months. They are generally benign however; they are of great concern to the parents. Understanding the clinical profile of these seizures is crucial for effective management and counseling. The current study tried to evaluate the clinical profile and seizure characteristics of children presenting with febrile seizures at our hospital. Materials and Methods: This cross-sectional observational study was conducted on 74 children aged 6–60 months from July to December 2024. A detailed history and clinical examination were done for each case. Relevant investigations and laboratory tests were done for all cases. Data was recorded using a predesigned proforma and analyzed by SPSS version 25 for statistical analysis. Results: Most of the children in this study were between 13 and 36 months old (62.2%), and just over half were boys (51.4%). About three-quarters (77%) of the cases involved simple febrile seizures. In most children, the seizures happened within 24 hours of developing a fever. Approximately one-third of the children had a family history of seizures (32.4%), and this was more common among those with simple febrile seizures. The most frequent cause of fever was an upper respiratory tract infection (54.1%). Nearly half of the children showed an increase in white blood cells (45.9%). Cerebrospinal fluid (CSF) examination was normal in all cases. There was no significant difference in hemoglobin levels between the different types of seizures. Conclusion: Febrile seizures occurred in children aged 1 – 3 years most of these were simple in nature and occurred following respiratory tract infections. Family history of seizures and early fever onset were significant predictors. Early diagnosis and appropriate evaluation and treatment play a key role in managing febrile seizures effectively. Keywords: Febrile Seizures, Respiratory Tract Infections, Pediatric Age Group, Complex Seizures.

Background: Pregnancy-related acute kidney injury (PRAKI) remains a significant contributor to maternal and fetal morbidity and mortality, particularly in developing countries. Though the incidence has declined due to improved antenatal care, conditions like preeclampsia, sepsis, and obstetric hemorrhage still play a major role in the etiology of PRAKI in India (Goplani et al., 2008; Prakash et al., 2010). Objectives of the study is to evaluate the clinical characteristics, etiological factors, maternal and fetal outcomes in cases of PRAKI admitted to a tertiary care hospital. Materials and Methods: A prospective observational study was conducted at Guntur Medical College, Guntur. Women aged 18–45 years, of any gestational age or within 6 weeks postpartum, diagnosed with PRAKI based on kidney disease improving Global Outcomes (KDIGO) criteria, were included. Patients with chronic kidney disease or non-obstetric causes of AKI were excluded. Data on etiology, clinical presentation, management, and outcomes were recorded and analyzed using descriptive statistics. Results: The predominant causes of PRAKI were hypertensive disorders of pregnancy (preeclampsia/eclampsia), sepsis, and postpartum hemorrhage. Most patients presented in the third trimester or early postpartum period. A significant proportion required dialysis, and maternal mortality was observed in cases complicated by multiorgan failure. Fetal outcomes were adversely affected in patients with severe renal impairment, with a notable incidence of preterm delivery and stillbirth. Conclusion: PRAKI continues to pose a considerable threat to maternal and neonatal health. Early diagnosis, prompt management of obstetric complications, and access to critical care facilities are essential to improve outcomes. Increased awareness and strengthening of maternal health services at the primary and secondary levels may help in reducing the incidence and severity of PRAKI. Keywords: Pregnancy-related acute kidney injury, PRAKI, maternal morbidity, fetal outcomes, sepsis, preeclampsia, KDIGO, tertiary care hospital.

Background: Pediatric cataract is a leading cause of childhood blindness. If is untreated it can lead to social, emotional and economical burden to their family and society. Objective: To study long term visual outcomes and binocular recovery in children undergoing cataract surgery and to determine the factors affecting visual acuity and stereopsis in children undergoing cataract surgery. Materials and Methods: This Cross sectional observational study was conducted in Department of Ophthalmology, King George’s Medical University (KGMU), Lucknow after getting approval from the institutional ethical committee. Informed written consent was taken from parent of each child for the study. Duration of study was One year. Results: Mean distance visual acuity of 0.8 LogMAR and mean near stereopsis of 158 seconds of arc is achieved in the long term. The eventual visual outcomes are not related to delay in surgery or laterality of cataract. Better stereopsis is achieved in absence of ocular comorbidities. In children below 2 years of age myopic shift in faster in children left myopic initially than those left hypermetropic. Early surgery and moderate hypermetropia in the immediate postoperative period favour better long term stereopsis. Best visual acuity is achieved in presence of mild long term residual hypermetropia. Conclusion: Early diagnosis and management of Pediatric Cataract may improve the visual outcomes. Screening of preschool children may help in early diagnosis Keywords: Visual Outcome, Children, Cataract Surgery.

Background: This study aims to estimate the prevalence of malnutrition among children aged 5–9 years in an urban slum and assess its association with various socio-demographic variables. The prevalence of malnutrition among school-age children is a significant public health concern, and urban slum children face compounded risks due to socio-economic challenges. Malnutrition in this age group often remains overlooked by nutrition programs, which tend to focus more on children under five and late adolescents. Materials and Methods: A cross-sectional analytical study was conducted among 283 children aged 5–9 years in a Mumbai urban slum, selected using systematic random sampling. Data collection was carried out through a pre-tested semi-structured questionnaire, anthropometric measurements, and clinical assessments based on WHO growth standards and the Rashtriya Bal Swasthya Karyakram (RBSK) criteria. Statistical analysis was performed using SPSS version 21.0, with associations tested using Chi-square or Fisher’s exact test. Logistic regression was applied to identify independent predictors of malnutrition, considering a significance level of p<0.05. Results: The prevalence of malnutrition in the study population was 52.7%. Statistically significant associations were found between malnutrition and several socio-demographic variables, including male sex (p=0.005), father's elementary occupation (p=0.002), non-school enrollment (p=0.003), younger maternal age (p<0.005), and financial hardship (p<0.005). Logistic regression analysis identified male sex, non-enrollment in school, financial difficulties, a higher number of siblings, and not availing RCH services as significant independent predictors of malnutrition. Conclusion: This study highlights the high burden of malnutrition among children aged 5–9 years in urban slums, with several socio-demographic factors significantly contributing to the risk. Targeted nutrition interventions and strengthened school and community health programs are urgently needed to address malnutrition in this vulnerable age group. These findings underscore the importance of extending public health services to include mid-childhood nutrition monitoring. Keywords: Malnutrition, School-age children, Urban slums, Socio-demographic factors, Nutritional status.

Background: Cervical carcinoma continues to be one of the major causes of cancer morbidity and mortality in Indian women. Although Pap smear is the most common method for detecting early cervicitis histopathology is still the reference standard for accurate diagnoses. The purpose of this study was to determine his-topathological spectrum of cervical lesions of women with abnormal Pap smears and to find out concordance between cytological and histopathological findings. Materials and Methods: A cross-sectional analytical study was conducted over two years at a tertiary care hospital in India. A total of 60 women with abnormal Pap smear results were enrolled. Cytological findings were classified using the 2014 Bethesda system. All participants underwent colposcopy-guided cervical biopsies, which were histopathologically examined. The correlation between cytological and histological diagnoses was analyzed, and the sensitivity, specificity, and accuracy of the Pap smear in detecting high-grade lesions (CIN II and above) were calculated. Results: The most affected age group was 35–44 years. Cytologically, high-grade squamous intraepithelial lesion (HSIL) was the most common abnormality (33.3%). Histopathology revealed CIN I in 26.7%, CIN II/III in 33.3%, and carcinoma in 16.6% of cases. The overall diagnostic accuracy of the Pap smear in detecting CIN II and above was 81.7%, with a sensitivity of 86.2%, specificity of 78.6%, and kappa agreement of 0.63. Concordance was highest for HSIL (85%) and lowest for ASC-US (50%). Conclusion: Pap smear remains a valuable tool for cervical cancer screening, particularly for high-grade lesions. However, histopathological confirmation is essential, especially in low-grade or ambiguous cytological findings. Strengthening cytology-biopsy correlation can improve early detection and prevent progression to invasive cervical cancer. Keywords: Pap smear, Cervical lesions, Cytology-histology correlation, CIN, Cervical cancer screening, Histopathology, Bethesda system.

Background: Mpox, formerly known as monkeypox, has emerged as a public health concern globally. Early detection, awareness, and preventive behaviors are crucial, particularly among university students due to their high social mobility. Objective: This study aimed to compare the awareness, knowledge, and attitudes towards Mpox among medical and non-medical university students. Materials and Methods: This cross-sectional comparative study was conducted at Patna University and PMCH Patna from February to June 2025. A total of 500 participants were enrolled, comprising 250 medical students from PMCH, Patna and 250 non-medical students from Patna University. Data were collected through a structured, self-administered questionnaire specifically developed for this research. Results: The mean age of participants was 21.86 ± 2.33 years. Male respondents constituted 64.4% of the sample. Awareness that Mpox is a contagious viral disease was significantly higher among medical students (72%) compared to non-medical students (43.6%) (p < 0.001). Similarly, knowledge regarding transmission and prevention was notably better in medical students. Attitudes towards Mpox prevention were also more positive in the medical group, with 91.2% supporting vaccination compared to 68.8% among non-medical students (p < 0.001). Social media was identified as the primary source of information by 55% of respondents. Conclusion: Medical students demonstrated significantly better knowledge and more proactive attitudes towards Mpox compared to non-medical students. The findings highlight a need for targeted health education initiatives focusing on non-medical student populations to ensure broader community protection against emerging infectious diseases like Mpox. Keywords: Mpox, Student, Awareness, Contagious.

Background: Anaemia is a significant public health challenge in India. Iron deficiency anaemia results in impaired cognitive and motor development in children and decreased work capacity in adults. The effects are most severe in infancy and early childhood. In pregnancy, iron deficiency anaemia can lead to perinatal loss, prematurity and low birth weight (LBW) babies1. Objective: 1. To estimate the effect of anemia mukt bharat utilization services of anaemia in Mothers (having children 6-59 months) in Kannauj district.2. To estimate the effect of anemia mukt bharat utilization services in children 6-59 months in Kannauj district. 3. To see the effects of advocacy of Mothers (having children of 6-59 months) in reducing the prevalence of anaemia in mothers and children. Materials and Methods: This Interventional study was conducted from July 2023 to March 2025 at was conducted in district kannauj in both rural urban areas from department of community medicine Dr BRRA GMC Kannauj. 20 clusters was selected- 10 in urban areas as municipal wards and 10 villages in rural areas by multistage random sampling. It included 189 study subjects i.e i.e Mothers of children 6-59 months and their children in age 6-59 months . a pre tested semi structure interview schedule is used and digital hemoglobinometer for Hb estimation. Results: statistically significant difference is found P value <.05 on applying paired T test between pre and post interventional data of following variables like Hb levels of children of study subjects, levels of Hb of study subjects, knowledge of number of services offered in anemia mukt bharat Abhiyan, knowledge number of food items rich in iron, average duration of IFA supplementation in days. Conclusion: According to this study, the advocacy of mothers of children 6-59 months can significantly affect these values. Keywords: Anemia, Anemia Mukt District, Advocacy of Mothers.

Background: Tuberculosis (TB) continues to pose a formidable public health challenge globally, and particularly in India, which carries the highest TB burden worldwide.[1] the effectiveness of any public health program, including the NTEP, is not solely determined by its reach but also by the quality of services it delivers. Objectives- To assess the KAP GAP of treatment services and other NTEP services among the general public and healthcare professionals and to determine the satisfaction level of patients in locality regarding NTEP treatment services. Materials and Methods: Patient were interviewed on preformed questionnaire regarding awareness on TB and services provided by the program Targets and activities done by the program coordinators and how satisfactory they are with the program implementation status was assessed along with ASHA. Results: Around 77.5 percent patients think transmission of TB cab be prevented and 95.1 percent think that TB can be cured. . Majority of ASHA heard about MDR TB (65%). Almost all ASHA knew about the DBT Nikshay Poshan Scheme. Conclusion: Significant KAP-GAP was found in this study regarding TB in TB patients and primary health care giver so the Health education interventions programme on TB needs to be intensified among the community members to improve TB awareness and reduce transmission. Keywords: Tuberculosis, Primary Care giver, knowledge, satisfaction level.

Background: Fluid resuscitation remains central to ICU management but risks fluid overload, complicating outcomes in critically ill patients. Passive leg raising (PLR) is a reversible preload challenge used to assess fluid responsiveness. Carotid Doppler indices, such as corrected carotid flow time (ccFT) and peak systolic velocity (Vmax), may provide non-invasive surrogates of cardiac output (CO) changes, but evidence remains limited. The objective is to assess the correlation between PLR-induced changes in cardiac output (CO) and carotid Doppler indices (ccFT and Vmax) as surrogates of fluid responsiveness in mechanically ventilated ICU patients. Materials and Methods: This prospective pre-post observational study included 50 mechanically ventilated ICU patients aged 20–60 years. CO was measured using non-invasive esCCO monitoring, and ccFT (using Wodey’s correction) and Vmax were recorded via carotid Doppler before and 1 minute after PLR. Patients with valvular heart disease, pregnancy, atrial fibrillation, or inability to tolerate PLR were excluded. Statistical analysis assessed changes in ccFT and Vmax with CO following PLR. Results: Among 50 patients, 72% were fluid responders (≥10% CO increase post-PLR). Responders showed a mean CO increase of 19.0 ± 8.0% versus 4.0 ± 3.0% in non-responders (p<0.0001). ΔccFT was significantly higher in responders (49.4 ± 46.4 ms) compared to non-responders (12 ± 18.8 ms; p=0.0009). ROC analysis for ΔccFT showed an AUC of 0.71 (p=0.024), with a cut-off >7.58 ms yielding 71.4% sensitivity and 75% specificity. No significant changes in Vmax were observed between groups (p=0.2527). Conclusion: PLR-induced changes in ccFT correlate significantly with CO changes, supporting ccFT as a reliable non-invasive surrogate for fluid responsiveness assessment. However, Vmax showed no significant correlation. Further large-scale studies are warranted to validate carotid Doppler indices as standard bedside tools for fluid responsiveness assessment in critical care. Keywords: Fluid responsiveness, passive leg raise, carotid Doppler, corrected carotid flow time, peak systolic velocity, cardiac output, critical care.

Background: Facial wound closure plays a critical role in surgical outcomes, particularly regarding healing, infection control, patient comfort, and cosmetic appearance. Traditional sutures, while effective, are associated with prolonged operative time and increased postoperative care. Tissue adhesives, particularly cyanoacrylate-based formulations, have emerged as alternatives offering quicker application and reduced tissue trauma. This study compares the effectiveness of cyanoacrylate tissue adhesive with conventional polypropylene sutures in facial laceration management. Materials and Methods: A prospective clinical study was conducted on 30 patients aged 15–40 years with facial lacerations, randomly assigned to two groups (n=15 each). Group S received wound closure using polypropylene sutures, while Group T was treated with isoamyl-2-cyanoacrylate adhesive. Parameters assessed included pain (Visual Analog Scale) on postoperative days 3 and 7, time required for closure, wound infection and inflammation on days 7 and 14, dehiscence, and aesthetic outcome (evaluated on days 1, 7, and 24 using a 6-point cosmetic score). Results: Group T (glue) showed significantly lower mean pain scores on day 3 (1.4 ± 0.63) and day 7 (0.33 ± 0.61) compared to Group S (suture) with scores of 3.86 ± 0.91 and 1.80 ± 0.67 respectively (p < 0.001). The average time for closure was shorter in Group T (1.06 ± 0.45 mins) versus Group S (5.86 ± 1.32 mins). Infection rates on day 14 were 20% in Group T and 46.7% in Group S. Inflammation was milder and resolved earlier in Group T. Wound dehiscence on day 14 occurred in 13.3% of Group T and 60% of Group S. Cosmetic scores were more favorable in Group T on day 24 (mean 0.80) compared to Group S (mean 2.46). Conclusion: Cyanoacrylate tissue adhesive demonstrated superior performance over polypropylene sutures in terms of reduced pain, quicker closure, lower infection and dehiscence rates, and better esthetic results. It offers a reliable, patient-friendly alternative for facial wound closure. Keywords: Cyanoacrylate, Facial laceration, Wound closure, Tissue adhesive, Polypropylene sutures, Esthetic outcome, Postoperative infection, Wound healing.

Background: Stomach cancer is a major health challenge globally, with particularly high incidence rates in Northeast India. Tobacco use, a significant risk factor, contributes to cancer progression through genetic and oxidative damage. This study examines the socio-demographic profiles, lifestyle factors, and clinical outcomes of stomach cancer patients, focusing on the role of tobacco use and highlighting barriers to timely diagnosis and treatment in this region. Materials and Methods: A retrospective study was conducted at the State Cancer Institute, Gauhati Medical College, analyzing data from 70 stomach cancer patients recorded in the Hospital-Based Cancer Registry for 2022. Detailed socio-demographic and clinical information was extracted, including tobacco use patterns, disease stages, and treatment modalities. Statistical tools were used to assess associations between risk factors and disease progression. Results: The cohort comprised 57.1% males and 42.9% females, predominantly from economically disadvantaged backgrounds. Smokeless tobacco use was reported in 38.6% of cases, while 31.4% engaged in smoking. Most patients (45.7%) were diagnosed at stage IV, with adenocarcinoma as the dominant histological type (88.6%). A notable 37.1% of patients refused treatment, citing socio-economic constraints. Mortality rates were high, with 62.9% of patients deceased at the time of follow-up. Conclusion: Tobacco use is a critical determinant of stomach cancer incidence and progression in Northeast India, compounded by socio-economic disparities and late-stage diagnoses. Urgent public health interventions are needed to reduce tobacco consumption, improve early detection, and enhance access to treatment. This study provides valuable insights for shaping targeted cancer control policies in the region. Keywords: Gastric cancer, Tobacco consumption, Socioeconomic factor, Northeast India, Late-stage diagnosis.

Recurrent pregnancy loss (RPL) is a distressing clinical condition affecting a significant percentage of reproductive-aged women. This prospective cross-sectional study at Gauhati Medical College and Hospital aimed to assess the prevalence of RPL and identify associated risk factors in a regional cohort. Of the 798 women studied, 8.27% had RPL.Risk factors such as advanced maternal age, obesity, subclinical hypothyroidism, antiphospholipid antibodies, uterine anomalies, and elevated blood pressure were found to be significantly associated with RPL. These findings underline the importance of early evaluation and multidisciplinary intervention in women with a history of pregnancy loss. Keywords: Recurrent Pregnancy Loss, Antiphospholipid antibodies, Body Mass Index, Ultrasound, Thyroid Peroxidase Antibodies.

Background: Cervical cancer remains a significant public health challenge, especially in low- and middle-income countries like India, where effective screening is often limited. This study aimed to evaluate and compare the diagnostic accuracy of Pap smear and HPV DNA testing in detecting cervical neoplasia. Materials and Methods: A prospective comparative study was conducted at the Department of Obstetrics and Gynaecology, Gauhati Medical College and Hospital, from 2024 to 2025. A total of 100 sexually active women aged 30–65 years underwent both Pap smear testing and HPV DNA typing using the PaxView® HPV16/18/Others MPCR-ULFA Kit. Abnormal cases were further evaluated by colposcopy and cervical biopsy. Data were analyzed using SPSS version 26. Results: Pap smear showed a sensitivity of 44.44% and specificity of 95.60%, while HPV DNA testing had a sensitivity of 100% and specificity of 92.31%. High-risk HPV types, especially HPV-16, showed a strong correlation with histologically confirmed high-grade lesions. Co-testing improved diagnostic yield, and a significant correlation was observed between abnormal cytology/HPV results and biopsy-proven pathology (p = 0.001). Conclusion: HPV DNA testing demonstrates superior sensitivity compared to Pap smear and should be integrated into routine cervical cancer screening, especially for women aged 30–65. A co-testing approach significantly enhances diagnostic accuracy and enables early detection, thus reducing cervical cancer-related morbidity and mortality. Keywords: Pap smear, HPV DNA, cervical cancer, screening, cytology, biopsy, colposcopy, CIN, HSIL.

Background: "Lymph node" refers to a small, bean-shaped structure that is part of the lymphatic system, which plays a crucial role in the body’s immune defense. FNAC (Fine Needle Aspiration Cytology) is a minimally invasive diagnostic procedure used to obtain cell samples from a mass, swelling, or lymph node using a thin, hollow needle for microscopic examination. Aim: To study the non-neoplastic and neoplastic lesions of enlarged lymph nodes by FNAC in patients with lymphadenopathy in the Cytopathology laboratory, Pathology Department, P.D.U. Medical College & Hospital, Rajkot. Material and Methods: In our study, all clinically diagnosed cases of lymphadenopathy that presented to the Cytopathology Section for Fine Needle Aspiration Cytology (FNAC) over a period of five months, from January 2025 to May 2025, were included. Results: During a period of 5 months, a total 201 cases were reported. Out of 201 cases, 164 (81.59%) were non neoplastic whereas 37 (18.40%) were neoplastic cases. In the present study, lesions were observed across all age groups, ranging from 3 months to 80 years. The peak incidence of non-neoplastic lesions was noted in the age group of 21 to 40 years, whereas the peak incidence of neoplastic lesions was observed in individuals above 50 years of age. Out of 201 cases, 105 cases (52.23%) were males and 96(47.76%) cases were females. Conclusion: Understanding the pattern of lymphadenopathy is crucial for making a confident and conclusive diagnosis or for raising a strong clinical suspicion of an underlying disease. Keywords: Lymph nodes, FNAC, Lymphadenopathy.

Background: The laryngeal mask airway (LMA) is a popular choice for ambulatory patients owing to its swift airway. Propofol and sevoflurane compete for LMA insertion, with propofol relaxing airway reflexes and sevoflurane offering a non-pungent odor. This study examined the impact of anesthesia induction with sevoflurane and propofol on the characteristics of laryngeal mask airway (LMA) insertion in adult patients, focusing on the preference for propofol for its ability to suppress reflexes. Materials and Methods: This prospective, comparative study was conducted on 60 patients scheduled for elective minor surgical procedures under general anesthesia in the Department of Anesthesiology, Mahatma Gandhi Memorial Hospital, Warangal. The patients were divided into two groups, each comprising 30 patients. Before the initiation of the study, Ethical and Research Committee clearance was obtained from the Institutional Ethical Committee. Results: No significant differences were observed in age, sex, weight, height, BMI, or surgery duration. However, significant differences were observed in the time to loss of eyelash reflex, jaw relaxation, and successful LMA insertion. The number of attempts required for airway device insertion and ease of airway insertion complications were also significant factors. Additional propofol requirements were also noted. No significant differences were observed in the complications during anesthesia induction, coughing, gagging, or laryngospasm. Patient satisfaction showed no significant difference, but there was a significant difference in the incidence of nausea and vomiting between the two groups. Conclusion: This study compared hemodynamic changes during laryngeal mask airway (LMA) insertion using sevoflurane inhalation and propofol intravenous administration. The results showed significant differences in procedural aspects, with one group experiencing a shorter time to loss of eyelash reflex and successful insertion. The hemodynamic parameters showed no significant differences, but movement and apnea incidences were more frequent in one group. Both techniques are effective in maintaining hemodynamic stability and patient satisfaction but differ in procedural efficacy and specific complications. Keywords: Laryngeal mask airway, Propofol, Sevoflurane, Hemodynamic changes.

Background: Nicotine dependence remains a significant public health challenge in India. Repetitive transcranial magnetic stimulation (rTMS) is a promising neuromodulatory treatment, but interindividual variability in response necessitates identification of predictive factors. Aim: To identify clinical and sociodemographic predictors of rTMS efficacy in smoking cessation among Indian adults Materials and Methods: Fifty nicotine-dependent adults received high-frequency (10 Hz) rTMS over the left DLPFC, 5 days/week for 3 weeks. The primary outcome was a reduction in daily tobacco use. FTND scores were assessed at baseline, 3 weeks, and 6 weeks. Regression analysis identified predictors of treatment response. Results: Participants showed significant reductions in cigarette consumption and FTND scores (p<0.001). Predictors of better response included age < 40yrs, FTND score< 6, tobacco use < 10 years, no comorbid alcohol use, and absence of medical comorbidity. Conclusion: Sociodemographic and clinical characteristics predict rTMS outcomes. Personalized treatment selection can enhance smoking cessation success. Keywords: Repetitive Transcranial Magnetic Stimulation (rTMS), nicotine dependence, predictors, India, smoking cessation.

Background: Upper gastrointestinal tract disorders are among the most frequently encountered issues in clinical practice, often associated with significant morbidity and mortality. Endoscopic biopsy is a common procedure performed in hospitals to evaluate a range of both benign and malignant lesion. The aim is to determine the employment of endoscopic biopsies for the diagnosis of upper gastrointestinal tract lesions. Materials and Methods: The study was conducted in the Department of Pathology at the Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh. It was designed as a cross-sectional, observational, and prospective study, carried out over a period of 18 months and included 130 patients presenting with upper gastrointestinal (GI) tract symptoms indicative of ulcers, abnormal growths, or precancerous lesions. Results: Out of a total of 130 cases, 85 cases (65.39%) were classified as non-neoplastic, while 45 cases (34.61%) were identified as neoplastic. Histopathological analysis of esophageal lesions identified Squamous cell carcinoma (well differentiated and moderately differentiated) as the most prevalent diagnosis (08 cases each), particularly in the middle third of the esophagus. Adenocarcinoma was also significant, especially in the lower segment. In gastric lesions, gastritis was the most common finding, with adenocarcinoma predominantly affecting the antrum and pylorus. Conclusion: In conclusion, this study underscores the importance of integrating endoscopic and histopathological evaluations for accurate diagnosis and management of upper GI lesions. The findings also emphasize the diagnostic significance of proliferative endoscopic findings, which are strongly associated with malignancies. Keywords: upper GI disorders; Endoscopic biopsies; Squamous cell carcinoma; Adenocarcinoma.

Background: Two promising medications for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) are rectal indomethacin and diclofenac. It is still debatable if they have a preventive impact on PEP in individuals at ordinary risk. We conducted a prospective observational trial with these two drugs and observed their effects with respect to the incidence of post-operative abdominal pain and discomfort, of pre and post-operative serum amylase and lipase levels and the hospital stay in days after per rectal administration with indomethacin and diclofenac. Materials and Methods: A total of 46 patients undergoing ERCP were randomised into two groups for post ERCP per rectal suppository placement. Participants' baseline plasma amylase and lipase levels were measured prior to ERCP using blood samples, and these results were compared to post-intervention levels after 24 hours. Pain score was measured using VAS scale of pain. Length of stay at the hospital after developing PEP less than 3 days was considered to be mild, 4–10 days moderate and more than 10 days or complications requiring a pancreatectomy was considered as severe. Results: Both the groups were comparable with regards to pre and post-op amylase and lipase levels. Mean post-op pain as measure by VAS score at 24 hours after surgery was comparable. Mean hospital stay was comparable between study groups. Incidence of post-ERCP pancreatitis was comparable and observed as 8.7% each in both groups. In both study groups, one case each of mild and moderate pancreatitis seen. Incidence of adverse reactions was observed to be more in cases of Indomethacin group (26.5% vs 4.3%; p-0.069). Conclusion: The efficacy of indomethacin compared with diclofenac was similar, however, more adverse reactions were associated with use of Indomethacin. In conclusion, study recommends per rectal administered of NSAIDs, preferrable diclofenac before in every patient (without renal failure) undergoing ERCP. Keywords: ERCP, Pancreatitis, NSAIDS, Post ERCP.

Background: The liver is a vital organ that plays a crucial role in maintaining hemostasis. It synthesizes plasma proteins and blood clotting factors. Liver disorders can disrupt these functions, leading to derangements in coagulation factors. The liver's role in regulating hemostasis is complex, and disruption in this process can lead to bleeding and thrombotic complications. Coagulation tests are useful in the evaluation, management and assessment of prognosis of liver diseases. This study aimed to assess coagulation parameters—PT, APTT, and platelet count—among patients with liver diseases. Materials and Methods: A cross-sectional descriptive study was conducted in Department of Medicine and Pathology, Mandya Institute of Medical Sciences, Mandya. This study included 128 patients clinically diagnosed with liver disease who were divided into three categories – cirrhosis, viral hepatitis, and obstructive jaundice. The coagulation tests PT, APTT and Platelet count were performed and the results were evaluated in group. Coagulation profiles were evaluated using standard laboratory methods. Results: Among 128 patients, 64 had cirrhosis, 31 had viral hepatitis, and 33 had obstructive jaundice. Prolonged PT was observed in 87.5% (112/128) of cases, APTT in 41.4% (53/128), and thrombocytopenia in 32% (41/128). Cirrhotic bleeders had significantly higher PT and APTT values compared to non-bleeders. Conclusion: Coagulation abnormalities vary with different liver diseases, duration and severity of disorders. In cirrhosis, raised level of PT and APTT indicates damage to liver resulting in reduced production of coagulation proteins with increased risk of bleeding tendencies. Coagulation abnormalities are prevalent in liver disease and correlate with disease type and severity. Routine coagulation testing is crucial for early detection of bleeding risk and better clinical management. Keywords: Cirrhosis, Hepatitis, Coagulation Profile, Liver Disease, Thrombocytopenia.

Background: Touchscreen devices are an unavoidable part of daily life for medical students. Touchscreen device usage has seen a swift rise in India, significantly influencing individuals across all age groups, especially college-aged adolescents. “Ringxiety” or phantom ringing, which results from the excessive use of mobile phones, has been reported recently in India. There is an increasing need for counselling and awareness of the ill effects of touch screen devices in students and help them to resolve their problems. The aim is to assess the extent and purpose of touch screen device usage Materials and Methods: It was a cross-sectional study done at Government Medical College, Ratlam, M.P. among undergraduate students who were willing to participate. The calculated sample size based on prevalence of smartphone usage of a previous study by Basu et al was calculated as 277. So final sample size taken was rounded up and taken as 360, equally divided among 4 batches currently pursuing MBBS at Government Medical College, Ratlam. The data was collected through a standardised, pre-designed, pre-validated, semi-structured questionnaire using google forms, including Mobile Phone Addiction Scale (MPAS). Results: A total of 360 students participated in the study, comprising 176 males (49%) and 184 females (51%). The average age was 21.38 ± 1.76 years. Based on the median MPAS score, 173 participants (48.05%) were classified as addicts, while 187 participants (51.94%) were classified as non-addicts. The primary uses of touch screen devices among the participants were for entertainment (82.7%), academic purposes (79.9%), and communication (68.2%). Conclusion: Mobile phone addiction among medical students, linked to device use and data consumption, impacts well-being and calls for urgent intervention. Keywords: Cell Phone Addiction, Academic, Entertainment, Ringxiety, Touch screen devices, Nomophobia, Mobile Phone Addiction.